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Cited by 235Maternal and Neonatal HealthcareMaternal Mental Health During Pregnancy and PostpartumGlobal Maternal and Child Health

Integrated perinatal health framework

Misra, Dawn P, Guyer, Bernard, Allston, Adam·2003·American Journal of Preventive Medicine
DOI 10.1016/s0749-3797(03)00090-4
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Abstract

Background Despite great strides in improving prenatal care utilization among American women, key perinatal indicators have remained stagnant or worsened in the past decade, and the United States continues to rank near the bottom compared to other developed countries. A new approach is needed if we are to achieve improvements in perinatal health.Methods To propose a new framework that integrates a "life span" approach with a multiple determinants model.Results We recognize that (1) powerful influences on outcome occur long before pregnancy begins; (2) pregnancy outcome is shaped by social, psychological, behavioral, environmental, and biological forces; and (3) the demography of pregnancy has changed dramatically in the last few decades with more women delaying their first birth. Approaches that simultaneously consider the entire life span as well as multiple determinants may need to be adopted. We propose a framework that integrates these approaches and is supported by the research literature. The life span perspective focuses attention toward the preconceptional and interconceptional periods as targets for intervention in improving perinatal health. The multiple determinants model distinguishes among concepts of disease, health and functioning, and well-being for both women and their offspring.Conclusions Our intent is to influence how policymakers, public health professionals, clinicians, and researchers approach perinatal health.

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  • High stress and related mental illnesses influence maternal and fetal outcomes and also affect offspring health into adulthood.

    “High levels of stress and associated mental illnesses affect maternal and fetal outcomes, and also long-term offspring health into adulthood.”

    From Perinatal mental illness: Definition, description and aetiology (2014) · cites this paper as [6]

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Authors
Misra, D. P., Guyer, B., & Allston, A.
Affiliations
Johns Hopkins University (US)
Corresponding author
Misra, Dawn P
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2003-07
Volume
25
Issue
1
Pages
65-75
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/s0749-3797(03)00090-4
OpenAlex
W2105986652
Cited by
235
References
199
Citations by year
2026: 6 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 8 · 2020: 9 · 2019: 15 · 2018: 13 · 2017: 17 · 2016: 11 · 2015: 14 · 2014: 13 · 2013: 14 · 2012: 13
FWCI
9.92
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (U93 MC 00101)
Topics
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
perinatal health, preconception care, pregnancy outcomes, social determinants of health, maternal health, child health, health policy framework
MeSH terms
Family Planning Services, Female, Health Promotion, Humans, Life Expectancy, Maternal Health Services, Maternal Welfare, Policy Making, Pregnancy, Pregnancy Outcome, United States, Preconception Care, Models, Organizational

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