Safeguarding Mothers and Babies: The Future of Maternal-Fetal Medicine in Malaysia

22 May 2025

3 分钟阅读

Safeguarding Mothers and Babies: The Future of Maternal-Fetal Medicine in Malaysia

The World Health Organisation (WHO) has launched Healthy Beginnings, Hopeful Futures, a global initiative to reduce maternal and newborn mortality while emphasising maternal well-being beyond childbirth.

In Malaysia, Maternal-Fetal Medicine (MFM) plays a vital role in managing high-risk pregnancies, improving birth outcomes, and ensuring safer deliveries. While the country has made remarkable progress in maternal and newborn healthcare, challenges remain, particularly in handling complex pregnancies and ensuring equal access to specialised care. Strengthening MFM services is essential to improving the long-term health of both mothers and babies.

Malaysia’s Progress in Maternal and Newborn Health

Malaysia has seen significant improvements in maternal and newborn health over the decades. The maternal mortality ratio (MMR) decreased to 25.7 per 100,000 live births in 2023 (Department of Statistics Malaysia,2023) compared to 44 per 100,00 live births in the early 1990s, while the infant mortality rate fell to 6.7 per 1,000 live births from 10 per 1000 live births in the early 2000s. These positive trends reflect better healthcare access, improved obstetric care, and advances in neonatal medicine.

With the majority of births taking place in medical facilities, most Malaysian women have access to skilled care during the antenatal and postnatal period. Routine antenatal checkups, first-trimester screenings, fetal anomaly (abnormality) scans, and invasive diagnostic procedures have also contributed to better outcomes by enabling the early detection of complications.

However, despite these achievements, new challenges have emerged, particularly in managing high-risk pregnancies and ensuring that specialised services are accessible to all.

Challenges of Maternal and Newborn Health in Malaysia

One of the biggest challenges is the rising number of high-risk pregnancies, partly due to better screening and detection. Gestational Diabetes Mellitus (GDM) is becoming more common, affecting up to 18.3% of pregnancies (International Journal of Environmental Research and Public Health, 2022). The increasing number of overweight and obese pregnant women also raises the risk of preeclampsia, which is a type of pregnancy complication associated with high blood pressure and protein in the urine. Obese mothers also have higher risks of stillbirth and macrosomia (large birth weight babies). Additionally, as more women delay pregnancy, there has been a rise in fetal chromosomal abnormalities and pregnancy complications, emphasising the need for early intervention and specialised care.

Another major concern is the unequal access to specialised services, especially for women in rural and Indigenous communities. These populations face transportation barriers and delayed referrals, which can lead to increased complications. While Malaysia has well-equipped tertiary hospitals with fetal medicine units, the number of trained MFM specialists remains insufficient, leading to longer wait times and limited access to advanced care such as detailed fetal imaging and genetic testing.

Maternal health issues do not end after childbirth. Postpartum haemorrhage (PPH) continues to be a leading cause of maternal deaths in Malaysia (The Lancet Global Health,2023), despite efforts to improve emergency obstetric care. Postpartum depression (PPD) affects an estimated 10–15% of mothers, yet many do not receive proper mental health support due to stigma and lack of awareness (Malaysian Journal of Medical Research,2023). Additionally, women with a history of preeclampsia or GDM face an increased risk of developing cardiovascular disease later in life (European Journal of Obstetrics & Gynaecology,2023), underscoring the need for long-term maternal health monitoring.

Strengthening Maternal-Fetal Medicine for a Healthier Future

To further improve maternal and newborn health, Malaysia must enhance its MFM services by expanding access, improving screening and diagnostics, and strengthening postpartum care. Refining fetal monitoring and intervention protocols is essential, particularly for pregnancies affected by hypertension and diabetes, as early detection can lead to timely management and better outcomes. Increasing the number of trained MFM specialists will also help ensure that all women, regardless of location, receive high-quality care.

Implementing universal first-trimester screening for chromosomal abnormalities and early-onset preeclampsia is another crucial step. Early diagnosis can significantly reduce pregnancy complications by allowing for prompt medical interventions. At the same time, advancements in fetal therapy and neonatal care must be prioritised. Strengthening neonatal intensive care units (NICUS) and neonatal transport services will ensure that preterm and critically ill newborns receive the care they need, regardless of where they are born.

Beyond pregnancy and childbirth, long-term maternal health must be integrated into routine care. Women with a history of preeclampsia or GDM should receive regular cardiovascular screenings, as they have a higher risk of developing heart disease later in life. Postpartum depression must also be addressed more proactively, with greater access to mental health screening and counselling services to support mothers’ emotional well-being. Breaking the stigma surrounding maternal mental health is just as important as providing medical care.

Malaysia has made tremendous progress in maternal-fetal medicine, but continued efforts are needed to tackle high-risk pregnancies, improve access to specialised care, and enhance postnatal support. By expanding MFM services, advancing fetal diagnostics, and prioritising long-term maternal health, Malaysia can align with WHO’s Healthy Beginnings, Hopeful Futures campaign and work toward a future where every mother and baby receives the best possible care. Investing in maternal-fetal medicine today will ensure healthier generations for years to come.

This article first appeared in Parenthood, 12 May 2025.

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22 May 2025

3 分钟阅读