Maternal morbidity: Neglected dimension of safe motherhood in the developing world

In safe motherhood programming in the developing world, insufficient attention has been given to maternal morbidity, which can extend well beyond childbirth. For every woman who dies of pregnancy-related causes, an estimated 20 women experience acute or chronic morbidity. Maternal morbidity adversely affects families, communities and societies. Maternal morbidity has multiple causes, with duration ranging from acute to chronic, severity ranging from transient to permanent and with a range of diagnosis and treatment options. This article addresses six selected relatively neglected aspects of maternal morbidity to illustrate the range of acute and chronic morbidities that can affect women related to pregnancy and childbearing that are prevalent in developing countries: anaemia, maternal depression, infertility, fistula, uterine rupture and scarring and genital and uterine prolapse. Based on this review, recommendations to reduce maternal morbidity include: expand the focus of safe motherhood to explicitly include morbidity; improve data on incidence and prevalence of maternal morbidity; link mortality and morbidity outcomes and programming; increase access to facility- and community-based maternal health care and reproductive health care; and address the antecedents to poor maternal health through a lifecycle approach

Annual cyclicity in high-resolution stable carbon and oxygen isotope ratios in the wood of the mangrove tree Rhizophora mucronata

In the present study, the high-resolution stable carbon (13C/12C) and oxygen (18O/16O) isotope ratio profiles in the wood of the mangrove Rhizophora mucronata Lam., a tropical tree species lacking distinct growth rings, were investigated. Variations of both isotope ratios revealed a remarkable annual cyclicity with lowest values occurring at the latewood/earlywood boundary (April–May) and highest values during the transition from earlywood to latewood (October–November). Based on the current knowledge of the physiology of this mangrove species, as well as on the current literature available on high-resolution profiles of stable isotope ratios in tree rings, possible driving forces responsible for this seasonal pattern are discussed. The annual cyclicity, together with a conspicuous isotope pattern appearing in the El-Niño year 1997, promises great potential for tropical dendrochronology