Sub-Saharan Africa accounts for half of the world's burden of maternal, newborn and child death with over 13,000 mothers, newborns and children dying every day [1,2]. Improvements in maternal, newborn and child health are therefore among the most pressing health challenges in Africa.

To foster the international commitment, the UN-Millennium Development Goals defined the aim to reduce maternal mortality by three quarters and the mortality of children below the age of 5 years by two thirds until 2015 [3].

In Africa high rates of maternal and neonatal morbidity and mortality are a consequence of multiple causes including endemic infectious diseases (malaria, HIV/AIDS, tuberculosis), malnutri- tion and micronutrient deficiencies, child-birth complications, newborn illness and inadequate antenatal and perinatal care due to financial and logistic constraints in these resource poor regions [1,4,5]. Public health interventions such as intermittent preventive treatment of malaria, vitamin supplementation, insecticide treated bednets, skilled birth attendance and increasing the frequency and quality of antenatal care are therefore the cornerstone of current strategies to reduce pregnancy associated adverse health outcomes [6–9]. The identification of additional - yet underappreciated - preventable risk factors for adverse pregnancy outcome is necessary to further strengthen current efforts to reduce maternal and neonatal mortality.

 

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