{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:59:53Z","timestamp":1791557993544,"version":"4.3.4"},"reference-count":109,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-010128"],"award-info":[{"award-number":["INV-010128"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Global maternal and neonatal mortality rates remain unacceptably high. The postnatal period, encompassing the first hour of life until 42 days, is critical for mother-baby dyads, yet postnatal care (PNC) coverage is low. Identifying mother-baby dyads at increased risk for adverse outcomes is critical. Yet few efforts have synthesized research on proximate and distant factors associated with maternal and neonatal mortality during the postnatal period. This scoping review identified proximate and distant factors associated with maternal and neonatal mortality during the postnatal period within low- and middle-income countries (LMICs). A rigorous, systematic search of four electronic databases was undertaken to identify studies published within the last 11 years containing data on risk factors among nationally representative samples. Results were synthesized narratively. Seventy-nine studies were included. Five papers examined maternal mortality, one focused on maternal and neonatal mortality, and the rest focused on neonatal mortality. Regarding proximate factors, maternal age, parity, birth interval, birth order\/rank, neonate sex, birth weight, multiple-gestation, previous history of child death, and lack of or inadequate antenatal care visits were associated with increased neonatal mortality risk. Distant factors for neonatal mortality included low levels of parental education, parental employment, rural residence, low household income, solid fuel use, and lack of clean water. This review identified risk factors that could be applied to identify mother-baby dyads with increased mortality risk for targeted PNC. Given risks inherent in pregnancy and childbirth, adverse outcomes can occur among dyads without obvious risk factors; providing timely PNC to all is critical. Efforts to reduce the prevalence of risk factors could improve maternal and newborn outcomes. Few studies exploring maternal mortality risk factors were available; investments in population-based studies to identify factors associated with maternal mortality are needed. Harmonizing categorization of factors (e.g., age, education) is a gap for future research.<\/jats:p>","DOI":"10.1371\/journal.pone.0293479","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T18:28:37Z","timestamp":1700504917000},"page":"e0293479","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":30,"title":["Proximate and distant determinants of maternal and neonatal mortality in the postnatal period: A scoping review of data from low- and middle-income countries"],"prefix":"10.1371","volume":"18","author":[{"given":"Preston","family":"Izulla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Muriuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kiragu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2658-1032","authenticated-orcid":true,"given":"Melanie","family":"Yahner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Fonner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda Nabin Ara","family":"Nitu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Osir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farahat","family":"Bello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"de Graft-Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"pone.0293479.ref001","volume-title":"Trends in maternal mortality 2000 to 2020: estimates.","author":"WHO, UNICEF UNFPA, WORLD BANK GROUP and UNDESA\/Population Division","year":"2023"},{"key":"pone.0293479.ref002","first-page":"52","volume-title":"Levels and trends in child mortality report 2020","author":"UN Inter-agency Group for Child Mortality Estimation","year":"2020"},{"key":"pone.0293479.ref003","first-page":"1","volume-title":"Postnatal care of the mother and newborn 2013","author":"World Health Organization (WHO)","year":"2013"},{"key":"pone.0293479.ref004","article-title":"Newborns: improving survival and well-being.","author":"World Health Organization","year":"2020","journal-title":"Fact sheets"},{"issue":"10032","key":"pone.0293479.ref005","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1016\/S0140-6736(15)00519-X","article-title":"Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival.","volume":"387","author":"CG Victora","year":"2016","journal-title":"Lancet (London, England)."},{"issue":"4","key":"pone.0293479.ref006","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2471\/BLT.14.140996","article-title":"Inequities in postnatal care in low- and middle-income countries: a systematic review and meta-analysis","volume":"93","author":"V Langlois \u00c9","year":"2015","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0293479.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-020-02866-3","article-title":"Sebuwufu D ogratious. 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