Examining the impact of poverty on maternal health: Adverse pregnancy   outcomes, contributing factors, and strategies for improvement

S. Janaki; S. Prabakar

doi:10.31893/multiscience.2025209

Keywords:

Abstract

The relationship between poverty and maternal health is a critical public health concern, with significant adverse outcomes for pregnancy and childbirth. This paper examines the impact of poverty on pregnancy outcomes such as abortion, infant death, perinatal mortality, stillbirth, heartbeat problems, neonatal and postneonatal death, and preterm birth. An analysis is conducted on many factors including racial and ethnic disparities, access to health services, pre-eclampsia, depression, stress, nicotine and substance use, nutritional status, intimate partner violence, short interpregnancy intervals, and infectious diseases. Strategies to mitigate these adverse outcomes and improve maternal health are discussed, highlighting the urgent need for targeted interventions to improve maternal health among impoverished populations.
References
1. Akhter, S., Dasvarma, G. L., & Saikia, U. (2020). Reluctance of women of lower socio-economic status to use maternal healthcare services: Does only cost matter? PLOS One, 15(9), e0239597. https://doi.org/10.1371/journal.pone.0239597
2. Bhatia, M., Dwivedi, L. K., Banerjee, K., Bansal, A., Ranjan, M., & Dixit, P. (2021). Pro-poor policies and improvements in maternal health outcomes in India. BMC Pregnancy and Childbirth, 21(1), 389. https://doi.org/10.1186/s12884-021-03848-5
3. Burns, P. A., Zunt, J. R., Hernandez, B., Wagenaar, B. H., Kumar, M., Omolo, D., & Breinbauer, C. (2020). Intimate partner violence, poverty, and maternal health care-seeking among young women in Kenya: A cross-sectional analysis informing the new sustainable development goals. Global Social Welfare, 7(1), 1-13. https://doi.org/10.1007/s40609-019-00163-2
4. Cubbin, C., Kim, Y., Vohra-Gupta, S., & Margerison, C. (2020). Longitudinal measures of neighborhood poverty and income inequality are associated with adverse birth outcomes in Texas. Social Science & Medicine, 245, 112665. https://doi.org/10.1016/j.socscimed.2019.112665
5. Dahab, R., & Sakellariou, D. (2020). Barriers to accessing maternal care in low-income countries in Africa: A systematic review. International Journal of Environmental Research and Public Health, 17(12), 4292. https://doi.org/10.3390/ijerph17124292
6. Govindasamy, R., Periyasamy, S., Narayanan, M., Balaji, V. R., Dhanasekaran, M., & Karthikeyan, B. (2020). The influence of nonsurgical periodontal therapy on the occurrence of adverse pregnancy outcomes: A systematic review of the current evidence. Journal of Indian Society of Periodontology, 24(1), 7-14. https://doi.org/10.4103/jisp.jisp_347_19
7. Hansen, A., & Moloney, M. (2020). Pregnancy-related mortality and severe maternal morbidity in rural Appalachia: Established risks and the need to know more. The Journal of Rural Health, 36(1), 3-8. https://doi.org/10.1111/jrh.12368
8. Jardine, J., Walker, K., Gurol-Urganci, I., Webster, K., Muller, P., Hawdon, J., & van der Meulen, J. (2021). Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: A national cohort study. The Lancet, 398(10314), 1905-1912. https://doi.org/10.1016/S0140-6736(21)01783-3
9. Jeena, P. M., Asharam, K., Mitku, A. A., Naidoo, P., & Naidoo, R. N. (2020). Maternal demographic and antenatal factors, low birth weight and preterm birth: Findings from the mother and child in the environment (MACE) birth cohort, Durban, South Africa. BMC Pregnancy and Childbirth, 20, 1-11. https://doi.org/10.1186/s12884-020-03172-9
10. Kassa, G. M., Arowojolu, A. O., Odukogbe, A. T. A., & Yalew, A. W. (2021). Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. PLOS One, 16(9), e0257485. https://doi.org/10.1371/journal.pone.0257485
11. Lacey, R. E., Howe, L. D., Kelly-Irving, M., Bartley, M., & Kelly, Y. (2022). The clustering of adverse childhood experiences in the Avon Longitudinal Study of Parents and Children: Are gender and poverty important? Journal of Interpersonal Violence, 37(5-6), 2218-2241. https://doi.org/10.1177/0886260519857165
12. Lopez-Littleton, V., & Sampson, C. J. (2020). Structural racism and social environmental risk: A case study of adverse pregnancy outcomes in Louisiana. In Three Facets of Public Health and Paths to Improvements (pp. 353-380). Academic Press. https://doi.org/10.1016/B978-0-12-816015-6.00013-2
13. Ma, Y., Gao, Y., Li, J., Sun, A., Wang, B., Zhang, J., & Rozelle, S. (2020). Maternal health behaviors during pregnancy in rural Northwestern China. BMC Pregnancy and Childbirth, 20, 1-13. https://doi.org/10.1186/s12884-020-02946-5
14. Muglia, L. J., Benhalima, K., Tong, S., & Ozanne, S. (2022). Maternal factors during pregnancy influencing maternal, fetal, and childhood outcomes. BMC Medicine, 20(1), 418. https://doi.org/10.1186/s12916-022-02561-z
15. Olson, D. M., & Metz, G. A. (2020). Climate change is a major stressor causing poor pregnancy outcomes and child development. F1000Research, 9. https://doi.org/10.12688/f1000research.25392.1
16. Premkumar, A., Debbink, M. P., Silver, R. M., Haas, D. M., Simhan, H. N., Wing, D. A., Grobman, W. A. (2020). Association of acculturation with adverse pregnancy outcomes. Obstetrics & Gynecology, 135(2), 301-309. https://doi.org/10.1097/AOG.0000000000003675
17. Shah, L. M., Varma, B., Nasir, K., Walsh, M. N., Blumenthal, R. S., Mehta, L. S., & Sharma, G. (2021). Reducing disparities in adverse pregnancy outcomes in the United States. American Heart Journal, 242, 92-102. https://doi.org/10.1016/j.ahj.2021.07.006
18. van Daalen, K. R., Kaiser, J., Kebede, S., Cipriano, G., Maimouni, H., Olumese, E., & Oliver-Williams, C. (2022). Racial discrimination and adverse pregnancy outcomes: A systematic review and meta-analysis. BMJ Global Health, 7(8), e009227. https://doi.org/10.1136/bmjgh-2022-009227
19. Wang, E., Glazer, K. B., Howell, E. A., & Janevic, T. M. (2020). Social determinants of pregnancy-related mortality and morbidity in the United States: A systematic review. Obstetrics & Gynecology, 135(4), 896-915. https://doi.org/10.1097/AOG.0000000000003762

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How to cite

Janaki, S., & Prabakar, S. (2024). Examining the impact of poverty on maternal health: Adverse pregnancy outcomes, contributing factors, and strategies for improvement . Multidisciplinary Science Journal, 7(5), 2025209. https://doi.org/10.31893/multiscience.2025209

[1] Akhter, S., Dasvarma, G. L., & Saikia, U. (2020). Reluctance of women of lower socio-economic status to use maternal healthcare services: Does only cost matter? PLOS One, 15(9), e0239597. https://doi.org/10.1371/journal.pone.0239597

[2] Bhatia, M., Dwivedi, L. K., Banerjee, K., Bansal, A., Ranjan, M., & Dixit, P. (2021). Pro-poor policies and improvements in maternal health outcomes in India. BMC Pregnancy and Childbirth, 21(1), 389. https://doi.org/10.1186/s12884-021-03848-5

[3] Burns, P. A., Zunt, J. R., Hernandez, B., Wagenaar, B. H., Kumar, M., Omolo, D., & Breinbauer, C. (2020). Intimate partner violence, poverty, and maternal health care-seeking among young women in Kenya: A cross-sectional analysis informing the new sustainable development goals. Global Social Welfare, 7(1), 1-13. https://doi.org/10.1007/s40609-019-00163-2

[4] Cubbin, C., Kim, Y., Vohra-Gupta, S., & Margerison, C. (2020). Longitudinal measures of neighborhood poverty and income inequality are associated with adverse birth outcomes in Texas. Social Science & Medicine, 245, 112665. https://doi.org/10.1016/j.socscimed.2019.112665

[5] Dahab, R., & Sakellariou, D. (2020). Barriers to accessing maternal care in low-income countries in Africa: A systematic review. International Journal of Environmental Research and Public Health, 17(12), 4292. https://doi.org/10.3390/ijerph17124292

[6] Govindasamy, R., Periyasamy, S., Narayanan, M., Balaji, V. R., Dhanasekaran, M., & Karthikeyan, B. (2020). The influence of nonsurgical periodontal therapy on the occurrence of adverse pregnancy outcomes: A systematic review of the current evidence. Journal of Indian Society of Periodontology, 24(1), 7-14. https://doi.org/10.4103/jisp.jisp_347_19

[7] Hansen, A., & Moloney, M. (2020). Pregnancy-related mortality and severe maternal morbidity in rural Appalachia: Established risks and the need to know more. The Journal of Rural Health, 36(1), 3-8. https://doi.org/10.1111/jrh.12368

[8] Jardine, J., Walker, K., Gurol-Urganci, I., Webster, K., Muller, P., Hawdon, J., & van der Meulen, J. (2021). Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: A national cohort study. The Lancet, 398(10314), 1905-1912. https://doi.org/10.1016/S0140-6736(21)01783-3

[9] Jeena, P. M., Asharam, K., Mitku, A. A., Naidoo, P., & Naidoo, R. N. (2020). Maternal demographic and antenatal factors, low birth weight and preterm birth: Findings from the mother and child in the environment (MACE) birth cohort, Durban, South Africa. BMC Pregnancy and Childbirth, 20, 1-11. https://doi.org/10.1186/s12884-020-03172-9

[10] Kassa, G. M., Arowojolu, A. O., Odukogbe, A. T. A., & Yalew, A. W. (2021). Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study. PLOS One, 16(9), e0257485. https://doi.org/10.1371/journal.pone.0257485

[11] Lacey, R. E., Howe, L. D., Kelly-Irving, M., Bartley, M., & Kelly, Y. (2022). The clustering of adverse childhood experiences in the Avon Longitudinal Study of Parents and Children: Are gender and poverty important? Journal of Interpersonal Violence, 37(5-6), 2218-2241. https://doi.org/10.1177/0886260519857165

[12] Lopez-Littleton, V., & Sampson, C. J. (2020). Structural racism and social environmental risk: A case study of adverse pregnancy outcomes in Louisiana. In Three Facets of Public Health and Paths to Improvements (pp. 353-380). Academic Press. https://doi.org/10.1016/B978-0-12-816015-6.00013-2

[13] Ma, Y., Gao, Y., Li, J., Sun, A., Wang, B., Zhang, J., & Rozelle, S. (2020). Maternal health behaviors during pregnancy in rural Northwestern China. BMC Pregnancy and Childbirth, 20, 1-13. https://doi.org/10.1186/s12884-020-02946-5

[14] Muglia, L. J., Benhalima, K., Tong, S., & Ozanne, S. (2022). Maternal factors during pregnancy influencing maternal, fetal, and childhood outcomes. BMC Medicine, 20(1), 418. https://doi.org/10.1186/s12916-022-02561-z

[15] Olson, D. M., & Metz, G. A. (2020). Climate change is a major stressor causing poor pregnancy outcomes and child development. F1000Research, 9. https://doi.org/10.12688/f1000research.25392.1

[16] Premkumar, A., Debbink, M. P., Silver, R. M., Haas, D. M., Simhan, H. N., Wing, D. A., Grobman, W. A. (2020). Association of acculturation with adverse pregnancy outcomes. Obstetrics & Gynecology, 135(2), 301-309. https://doi.org/10.1097/AOG.0000000000003675

[17] Shah, L. M., Varma, B., Nasir, K., Walsh, M. N., Blumenthal, R. S., Mehta, L. S., & Sharma, G. (2021). Reducing disparities in adverse pregnancy outcomes in the United States. American Heart Journal, 242, 92-102. https://doi.org/10.1016/j.ahj.2021.07.006

[18] van Daalen, K. R., Kaiser, J., Kebede, S., Cipriano, G., Maimouni, H., Olumese, E., & Oliver-Williams, C. (2022). Racial discrimination and adverse pregnancy outcomes: A systematic review and meta-analysis. BMJ Global Health, 7(8), e009227. https://doi.org/10.1136/bmjgh-2022-009227

[19] Wang, E., Glazer, K. B., Howell, E. A., & Janevic, T. M. (2020). Social determinants of pregnancy-related mortality and morbidity in the United States: A systematic review. Obstetrics & Gynecology, 135(4), 896-915. https://doi.org/10.1097/AOG.0000000000003762

Abstract

References

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