Albarqi Mohammed Nasser
Family and Community Medicine Department, College of Medicine, King Faisal University, Hofuf 36291, Saudi Arabia.
Healthcare (Basel). 2025 May 6;13(9):1076. doi: 10.3390/healthcare13091076.
BACKGROUND/OBJECTIVES: Neonatal outcomes, including low birth weight, preterm birth, and neonatal mortality, pose significant global health challenges, particularly in low- and middle-income countries. Prenatal care has emerged as a critical intervention in mitigating these risks through medical, nutritional, and psychosocial support. This study aimed to systematically assess the effectiveness of prenatal care interventions in preventing neonatal outcomes across diverse settings.
A systematic review and meta-analysis were conducted according to PRISMA guidelines, with the protocol registered in PROSPERO (CRD42024601066). Fourteen peer-reviewed studies were included following a comprehensive search across five major databases. Eligible studies reported quantitative neonatal outcomes associated with prenatal care interventions, including nutritional supplementation, mental health services, telehealth, and routine antenatal care. Random-effects models were used for meta-analysis, and the risk of bias was assessed using RoB 2 and the Newcastle-Ottawa Scale.
Nutritional interventions, especially folic acid and iron supplementation, significantly reduced neonatal mortality by up to 40% (RR = 0.60, 95% CI: 0.54-0.68). High-quality prenatal care was associated with a 41% reduction in neonatal mortality. Psychosocial support reduced the risk of low birth weight and preterm birth, while telehealth interventions lowered NICU admissions in low-risk populations (RR = 0.88, 95% CI: 0.75-1.03). Heterogeneity was substantial (I = 70%), and publication bias was suggested.
Comprehensive prenatal care, integrating medical, nutritional, and mental health interventions, significantly improves neonatal outcomes. The global implementation of accessible, high-quality prenatal services is essential, particularly in underserved populations, to reduce neonatal morbidity and mortality.
背景/目的：新生儿结局，包括低出生体重、早产和新生儿死亡，给全球健康带来了重大挑战，尤其是在低收入和中等收入国家。产前护理已成为通过医疗、营养和心理社会支持来降低这些风险的关键干预措施。本研究旨在系统评估产前护理干预措施在不同环境下预防新生儿不良结局的有效性。
根据PRISMA指南进行系统综述和荟萃分析，方案已在PROSPERO（CRD42024601066）注册。在对五个主要数据库进行全面检索后，纳入了14项经同行评审的研究。符合条件的研究报告了与产前护理干预措施相关的定量新生儿结局，包括营养补充、心理健康服务、远程医疗和常规产前护理。采用随机效应模型进行荟萃分析，并使用RoB 2和纽卡斯尔-渥太华量表评估偏倚风险。
营养干预措施，尤其是叶酸和铁补充剂，可显著降低高达40%的新生儿死亡率（RR = 0.60，95% CI：0.54 - 0.68）。高质量的产前护理与新生儿死亡率降低41%相关。心理社会支持降低了低出生体重和早产的风险，而远程医疗干预措施降低了低风险人群入住新生儿重症监护病房的比例（RR = 0.88，95% CI：0.75 - 1.03）。异质性较大（I = 70%），并提示存在发表偏倚。
综合医疗、营养和心理健康干预措施的全面产前护理可显著改善新生儿结局。在全球范围内实施可及的、高质量的产前服务对于减少新生儿发病率和死亡率至关重要，尤其是在服务不足的人群中。
