Evidence map›Paper›PMID 25822529›Full record

ArticlePloS one2015

A color-coded tape for uterine height measurement: a tool to identify preterm pregnancies in low resource settings.

Fernando Althabe, Mabel Berrueta, Jennifer Hemingway-Foday, Agustina Mazzoni, Carolina Astoul Bonorino, Andrea Gowdak, Luz Gibbons, M B Bellad, M C Metgud, Shivaprasad Goudar and 20 more

Abstract read
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Fernando AlthabeInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Mabel BerruetaInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Jennifer Hemingway-FodayRTI International; Durham, North Carolina, United States of America.
Agustina MazzoniInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Carolina Astoul BonorinoInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Andrea GowdakInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Luz GibbonsInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
M B BelladKLE University's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
M C MetgudKLE University's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Shivaprasad GoudarKLE University's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Bhalchandra S KodkanyKLE University's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Richard J DermanChristiana Care, Newark, Delaware, United States of America.
Sarah SaleemDepartment of Community Health Sciences, Aga Khan University, Karachi Pakistan.
Samina IqbalDepartment of Obstetrics, Sobhraj Maternity Hospital, Karachi, Pakistan.
Syed Hasan AlaDepartment of Obstetrics, Sindh Government Qatar Hospital, Karachi Pakistan.
Robert L GoldenbergDepartment of Obstetrics and Gynecology, Columbia University, New York, New York, United States of America.
Elwyn ChombaUniversity Teaching Hospital, Lusaka, Zambia.
Albert ManasyanCentre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of North Carolina, Chapel Hill, North Carolina, United States of America.
Melody ChiwilaUniversity Teaching Hospital, Lusaka, Zambia.
Edna ImendaUniversity Teaching Hospital, Lusaka, Zambia.
Florence MbeweUniversity Teaching Hospital, Lusaka, Zambia.
Antoinette TshefuKinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.
Victor LokombaKinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.
Carl L BoseUniversity of North Carolina, Chapel Hill, North Carolina, United States of America.
Janet MooreRTI International; Durham, North Carolina, United States of America.
Sreelatha MelethRTI International; Durham, North Carolina, United States of America.
Elizabeth M McClureRTI International; Durham, North Carolina, United States of America.
Marion Koso-ThomasEunice Kennedy Shriver NICHD, Bethesda, Maryland, United States of America.
Pierre BuekensSchool of Public Health and Tropical Medicine, Tulane University, Louisiana, United States of America.
José M BelizánInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.

Funding

Zika in Pregnancy Supplemental Funding requestU01HD040636 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI MCCLURE, ELIZABETH M · 2001 to 2017
$37.5M
UAB/AKU Global Network Research UnitU01HD040607 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GOLDENBERG, ROBERT L · 2001 to 2012
$8.5M
UMKC-JNMC Global Network for Women's and Children's Health Research UnitU01HD042372 · NICHD · UNIVERSITY OF MISSOURI KANSAS CITY · PI DERMAN, RICHARD J · 2001 to 2012
$6.9M
Neonatal Resuscitation in Developing CountriesU01HD043464 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CARLO FONT, WALDEMAR A. · 2003 to 2012
$6.6M
Evidence-Based Global Health Interventions for Mothers and Children, ArgentinaU01HD040477 · NICHD · UNIVERSITY OF NORTH CAROLINA CHAPEL HILL · PI BUEKENS, PIERRE · 2001 to 2013
$5.6M
Safe Pregnancy by Infectious Disease Control in KinshasaU01HD043475 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BOSE, CARL · 2003 to 2008
$5.2M
CCHS-JNMC Global Network for Women's & Children's Health Research UnitU10HD076457 · NICHD · THOMAS JEFFERSON UNIVERSITY · PI DERMAN, RICHARD J · 2013 to 2017
$3.7M
A Strategy to Reduce Stunting of Growth in Early Infancy: a Global Network StudyU10HD076465 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BOSE, CARL · 2013 to 2017
$2.9M
NICHD NIH HHS U01 HD040477NICHD NIH HHS U01 HD040607NICHD NIH HHS U01 HD040636NICHD NIH HHS U01 HD042372NICHD NIH HHS U01 HD043464NICHD NIH HHS U01 HD043475NICHD NIH HHS U01 HD40477NICHD NIH HHS U10 HD076457NICHD NIH HHS U10 HD076465
6 · The paper itself

Abstract

introductionNeonatal mortality associated with preterm birth can be reduced with antenatal corticosteroids (ACS), yet <10% of eligible pregnant women in low-middle income countries. The inability to accurately determine gestational age (GA) leads to under-identification of high-risk women who could receive ACS or other interventions. To facilitate better identification in low-resource settings, we developed a color-coded tape for uterine height (UH) measurement and estimated its accuracy identifying preterm pregnancies.

methodsWe designed a series of colored-coded tapes with segments corresponding to UH measurements for 20-23.6 weeks, 24.0-35.6 weeks, and >36.0 weeks GA. In phase 1, UH measurements were collected prospectively in the Democratic Republic of Congo, India and Pakistan, using distinct tapes to address variation across regions and ethnicities. In phase 2, we tested accuracy in 250 pregnant women with known GA from early ultrasound enrolled at prenatal clinics in Argentina, India, Pakistan and Zambia. Providers masked to the ultrasound GA measured UH. Receiver operating characteristics (ROC) analysis was conducted.

results1,029 pregnant women were enrolled. In all countries the tapes were most effective identifying pregnancies between 20.0-35.6 weeks, compared to the other GAs. The ROC areas under the curves and 95% confidence intervals were: Argentina 0.69 (0.63, 0.74); Zambia 0.72 (0.66, 0.78), India 0.84 (0.80, 0.89), and Pakistan 0.83 (0.78, 0.87). The sensitivity and specificity (and 95% confidence intervals) for identifying pregnancies between 20.0-35.6 weeks, respectively, were: Argentina 87% (82%-92%) and 51% (42%-61%); Zambia 91% (86%-95%) and 50% (40%-60%); India 78% (71%-85%) and 89% (83%-94%); Pakistan 63% (55%-70%) and 94% (89%-99%).

conclusionsWe observed moderate-good accuracy identifying pregnancies ≤ 35.6 weeks gestation, with potential usefulness at the community level in low-middle income countries to facilitate the preterm identification and interventions to reduce preterm neonatal mortality. Further research is needed to validate these findings on a population basis.

Indexed as

Body Weights and MeasuresMonitoring, PhysiologicPremature BirthPrenatal CareAdultClinical CodingDeveloping CountriesFemaleGestational AgeHumansPregnancyROC CurveUterusYoung Adult

Identifiers

PMID25822529
PMCPMC4379082

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.