The aim of the systematic review and meta‐analysis is to determine the stress and stressors experienced by the parents of high‐risk neonates admitted to the neonatal intensive care unit (NICU) in India. We included both quantitative and qualitative studies. The Joanna Briggs Institute Critical Appraisal Checklist and Critical Appraisal Skill Programme checklist were used to assess the quality of included studies. A systematic search was conducted in PubMed, EMBASE, SCOPUS, EBSCOhost, Web of Science, ProQuest, Microsoft Academic, DOAJ, Indian Citation Index, and J‐Gate to identify relevant studies. Additionally, online hand searching was performed on Indian websites of relevant institutions, women and child health departments, repositories, registries, and paediatric journals. Twelve of the 21 quantitative studies found that maternal stress was higher than fathers due to the separation from their babies and the medical condition of the neonate. One qualitative study reported that financial burden, alterations in the parenting role, and concern over domestic issues are significant causes of fathers' stress. A meta‐analysis of the included studies assessed the prevalence of maternal, paternal, and parental stress and reported that mothers experienced higher stress levels than fathers across all subscales. The most typical stressors for parents were changes in neonatal looks, behaviour, and altered parental roles. Beyond the immediate NICU care and interactions, other triggering factors of stress among parents must be considered to design multicomponent interventions in a local (Indian) context. Moreover, parental psychological support and regular counselling can be incorporated into the standard neonatal intensive care policy.

Introduction: Given the significant role of the gut microbiota in early immune and metabolic development, the impact of perinatal antibiotic administration on the neonatal gut microbiome remains a crucial area of investigation. This study examines how maternal and neonatal antibiotic exposure affects the composition of the gut microbiome in preterm infants. Methodology: A prospective controlled cohort study was conducted in the neonatal intensive care unit of a tertiary care hospital from January 2021 to September 2023. The study enrolled neonates with a gestational age of less than 37 weeks. Preterm infants were categorized into four groups based on exposure to maternal or neonatal antibiotics: the NE group (no exposure), IE group (infant exposure only), ME group (maternal exposure only), and IME group (both infant and maternal exposure). In the NE group, “No exposure” refers to participants whose mothers did not receive intrapartum antibiotics or whose neonates were not administered postnatal antibiotics prior to sample collection. Data on antibiotic use and microbiota composition from stool samples were collected and analyzed via the convection culture method. Results: This study included 182 preterm infants, yielding 364 stool samples. By day 4, the prevalence of Klebsiella pneumoniae increased significantly, reaching 70% in the IE group compared with 42.6% in the NE group (p < 0.001). Bifidobacterium spp. was more prevalent in the NE group than in the other groups on day 4 (57.4%, p = 0.019). The antibiotic-exposed groups (IE, ME, and IME groups) presented greater abundances of potentially pathogenic bacteria, such as Klebsiella pneumoniae and Escherichia coli, whereas beneficial bacteria, such as Bifidobacterium spp., were more abundant in the NE group. Conclusion: These findings suggest that perinatal antibiotic exposure is associated with significant changes in the neonatal gut microbiota, potentially increasing the pathogenic microbiota. Trial registration: The study was registered with the Clinical Trials Registry-India (CTRI) under the number CTRI/2020/11/029375 |http://ctri.nic.in/ on November 19, 2020.

Maternal and child health among tribal populations in Odisha, India, is significantly influenced by socio-economic, cultural, and infrastructural factors. Cultural practices, reliance on traditional medicine, and limited awareness of modern healthcare benefits shape health-seeking behavior. This scoping review synthesises evidence on health-seeking behaviour, healthcare utilisation, awareness of healthcare services, government policies, and barriers in tribal communities in Odisha, India. This scoping review was conducted following the Joanna Briggs Institute guidelines. We followed the Arksey and O'Malley methodological framework and applied the PAGER framework (Patterns, Advances, Gaps, Evidence for Practice, Research Recommendations) for quality of reporting. Studies were identified through systematic searches of international and Indian databases, Indian journal websites, organisational websites, repositories, and registries, focusing on health-seeking behaviour and healthcare utilisation among Odisha's tribal communities. Only English-language articles published between January 2011 and July 2024 were included. The methodological quality of the selected studies was independently assessed by two reviewers using the JBI Quality Assessment Checklist. A total of 39 studies, encompassing 36,613 participants, were included in the review. The findings highlight significant barriers to healthcare access among tribal communities, including poverty, illiteracy, cultural practices, geographic isolation, distance to healthcare centres, transportation availability and mistrust of government services. While some tribes have shown progress in adopting modern healthcare services, many continue to rely on traditional medicine and indigenous practices. Socio-cultural factors, such as patriarchal norms and religious rituals, further influence healthcare-seeking behavior. Government initiatives like the National Rural Health Mission and the Integrated Child Development Services have had some success in improving healthcare utilisation among tribal populations. However, strengthening community support, conducting village-level awareness campaigns, and implementing targeted educational interventions can play a transformative role in enhancing healthcare access and overall well-being. Improving maternal and child health in Odisha's tribal populations requires culturally sensitive approaches integrated with modern healthcare strategies. Enhancing awareness, infrastructure, and community health workers' roles can bridge access gaps while respecting tribal traditions.

Non-communicable diseases (NCDs) remain the leading cause of mortality in India, imposing a significant healthcare and economic burden. This study evaluate