The Considerations in Maternal Health and Labor

Annotated Bibliography
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Dunn, A. B., Jordan, S., Baker, B. J., & Carlson, N. S. (2017). The Maternal Infant Microbiome: Considerations for Labor and Birth. MCN. The American journal of maternal child nursing, 42(6), 318–325. https://doi.org/10.1097/NMC.0000000000000373
The considerations in maternal health and labor include the colonization of pathogens, the use of antibiotics, and the use of essential maternal procedures. Maternal health is dependent on the balance of the microorganisms in the mother to have an excellent maternal and child outcome. Microorganisms can penetrate and multiply in the uterus, resulting in newborn infection. The pathogens are transferred from the mother to the child as an early inoculation process, leading to chronic diseases in the child. These pathogens can colonize the umbilical cord, fetal membranes, placenta, and amniotic fluid. Gram-positive and gram-negative bacteria have been shown to cause infection. Remarkably, some of the identified pathogens include Escherichia coli, Bacteroidetes, and Prevotella tannerae. The pathogens can also translocate from other body parts to the female reproductive tract (i.e., from the gastrointestinal tract) (Dunn et al., 2017).
The most common route of birth is vaginal, comprising 68% of the cases. This process allows the child to pass through the vaginal canal and expose the pathogens that colonize the area. Lactobacillus species are often found in the vagina, helping maintain vaginal fluid pH to prevent the colonization of other bacteria. Good microflora passed to the child is essential for the development of the immune system. However, those that are pathogenic may cause infection in the child. By contrast, children born via caesarian section tend to have less good microflora, resulting in the immune system’s underdevelopment. These children often develop allergies (Dunn et al., 2017).
Antibiotic use may disturb the balance of reproductive tract microflora, allowing for the growth of pathogenic bacteria due to the reduction of protective microflora such as Lactobacillus species and Bifidobacteria. During labor, obstetricians prescribe antibiotics to reduce the possibility of infection after birth for both the mother and child. The issue was that these could cross the placental-fetal barrier and may affect the growth of the child. In addition, studies have shown that the child’s gastrointestinal tract undergoes dysbiosis secondary to the disruption in the natural flora due to intrapartum antibiotic administration. Lastly, procedures that can cause dysbiosis include intrauterine fetal heart rate measurement, cervical examination, urinary catheterization, antibiotic administration, kangaroo hug, and breastfeeding. (Dunn et al., 2017).
Fiscaletti, M., Stewart, P., & Munns, C. F. (2017). The importance of vitamin D in maternal and child health: a global perspective. Public health reviews, 38(1), 1-17. https://doi.org/10.1186/s40985-017-0066-3
The researchers investigated the vitamin D levels of the mother and the infant and the latter’s predisposition for vitamin D deficiency (VDD) and nutritional rickets (NR) associated with low levels of dietary calcium during pregnancy (Fiscaletti et al., 2017).
Calcium and Vitamin D are important in the growth and development of the skeletal system. Children and pregnant women have a higher risk than the general population of having these deficiencies. VDD results in osteomalacia, a condition resulting from the demineralization of the trabecular and cortical bones. It is often used in adults. Hence, appropriate for pregnant women. Conversely, the histological changes in VDD can be found in NR, which is a pediatric disease that causes dysfunction in chondrocyte maturation. It leads to the defective mineralization of growth plates. Thus, NR patients are characterized by skeletal abnormalities and short height (Fiscaletti et al., 2017).
The study revealed the results of the cohort investigation of Vitamin D levels among pregnant white women. The researchers found that most North West England mothers had Vitamin D insufficiency while a negligible number had a deficiency, comprising 27% and 7% of the total pregnant population, respectively. Furthermore, the rates change after birth, showing a progression of deficiency. Specifically, studies have shown that pregnant teenagers are predisposed to the condition (Womack et al., 2020).
Kim, S. (2020). Changes in Multiple and Different Tobacco Product Use Behaviors in Women Before and During Pregnancy: An Analysis of Longitudinal Population Assessment of Tobacco and Health Data. American Journal of Preventive Medicine, 59(4), 588-592...