The maternal history

Before we explore the process of examining the newborn baby, we must first consider what was going on for the mother during her pregnancy.

By undertaking a maternal history, the healthcare provider can make informed decisions for the newborn’s ongoing care. Understanding this history will help you anticipate the needs of the newborn and validate the physical findings

There are a number of maternal conditions and risk factors that might impact on the development of the fetus, but the following are the most common:

Maternal obesity

Obesity is increasing globally and obesity in pregnancy can be problematic for the mother, leading to:

• blood clotting disorders
• gestational diabetes (see below)
• high blood pressure (see below)
• obstructed labour (such as shoulder dystocia, where the baby’s shoulder becomes caught under the mother’s pubic bone during birth)
• postpartum haemorrhage (excessive blood loss following the baby’s birth)
• a need for instrumental delivery and caesarean section
• a higher incidence of congenital problems, prematurity, stillbirth and childhood obesity (Kain & Mannix, 2018).

Gestational diabetes mellitus (GDM)

With obesity on the rise, the incidence of GDM is also growing. GDM can affect the newborn in a number of ways, including:

• low birthweight
• large birthweight (macrosomia)
• birth trauma (if the baby is large) and
• metabolic, cardiovascular and neurological disorders (Nodine et al, 2016).

Maternal hypertension (high blood pressure)

When the mother has high blood pressure, it can reduce blood flow in the placenta. This is referred to as vasoconstriction (constriction of the blood vessels) of the uteroplacental circulation. It can result in the baby being born small for its gestational age (SGA) and can also increase the risk for stillbirth (Kain & Mannix, 2018).

Maternal infections

Viral infections in the mother are well-known teratogens (agents or factors, which cause malformation in the embryo). Viral maternal infections can lead to chorioretinitis (an inflammation of the retina of the eye), hearing loss, seizures, bleeding problems, jaundice and rash in the newborn.

Bacterial infections – in particular Group B streptococcus (GBS) are the most common bacterial infection. GBS infection in the newborn can result in respiratory distress and sepsis (Kain & Mannix, 2018).

Medications taken by the mother

In an ideal world, the woman’s pregnancy would be drug free. In reality, most mum’s-to-be will take some form of medication, however most do not cause any harm to the newborn. Drugs such as antidepressants are common in the West these days, and antidepressants such as selective serotonin reuptake inhibitor (SSRI) drugs have only mild adverse effects on the fetus. The pregnant woman should always check with her care provider and/or pharmacist before taking medications during pregnancy.

Your task

In the comments link below share your stories and experiences of maternal conditions impacting on the birth and health status of the newborn.

References

Kain, V. & Mannix, T (2018). Neonatal Nursing in Australia and New Zealand, 1st Edition. Australia: Elsevier.

Nodine, P.M., Hastings-Tolsa, M. & Arruda, J. (2016). Perinatal environment: effect on neonatal outcome. In Gardner, S.L., Carter B.S., Hines, M.E., Hernandez JA. Merenstein and Gardner’s Handbook of Neonatal Intensive Care. 8th ed. St Louis: Elsevier.