Trial reportReproductive health2016
The global network antenatal corticosteroids trial: impact on stillbirth.
Trial report in Reproductive health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01084096 (Trial of the Use of Antenatal Corticosteroids in Developing Countries), which is not on this map. Cited by 8 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Trial of the Use of Antenatal Corticosteroids in Developing Countries
Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.The Cochrane database of systematic reviews · 2020Pooled it
- Strategies for optimising antenatal corticosteroid administration for women with anticipated preterm birth.The Cochrane database of systematic reviews · 2020Pooled it
- Comparative analysis on the efficacy of antenatal corticosteroids in preterm newborns in a Kazakhstani Tertiary Care Hospital setting.World journal of clinical pediatrics · 2025Article
- Giants in Obstetrics and Gynecology Series: a profile of Robert L. Goldenberg, MD.American journal of obstetrics and gynecology · 2021Article
- Maternal and neonatal data collection systems in low- and middle-income countries for maternal vaccines active safety surveillance systems: A scoping review.BMC pregnancy and childbirth · 2021Article
- Antenatal Corticosteroids:Global health, science and practice · 2018Article
- Under-estimation of maternal and perinatal mortality revealed by an enhanced surveillance system: enumerating all births and deaths in Pakistan.BMC public health · 2018Article
- Reducing neonatal mortality associated with preterm birth: gaps in knowledge of the impact of antenatal corticosteroids on preterm birth outcomes in low-middle income countries.Reproductive health · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 15 institutions in 6 countries.
Funding
Abstract
backgroundAntenatal corticosteroids are commonly used to reduce neonatal mortality, but most research to date has been in high-resource settings and few studies have evaluated its impact on stillbirth. In the Antenatal Corticosteroids Trial (ACT), a multi-country trial to assess impact of a multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth, we found an overall increase in 28-day neonatal mortality and stillbirth associated with the intervention.
methodsThe ACT was a cluster-randomized trial conducted in 102 clusters across 7 research sites in 6 countries (India [2 sites], Pakistan, Zambia, Kenya, Guatemala and Argentina), comparing an intervention to train birth attendants at all levels of the health system to identify women at risk of preterm birth, administer corticosteroids and refer women at risk. Because of inadequate gestational age dating, the <5(th) percentile birth weight was used as a proxy for preterm birth. A pre-specified secondary outcome of the trial was stillbirth.
resultsAfter adjusting for the pre-trial imbalance in stillbirth rates, the ACT intervention was associated with a non-significant increased risk of stillbirth (aRR 1.08, 95 % CI, 0.99-1.17, p-0.073). Additionally, the stillbirth rate was higher in the term births (1.20 95 % CI 1.06-1.37, 0.004) and among those with signs of maceration (RR 1.18 (1.04-1.35), p = 0.013) in the intervention vs. control clusters. Differences in obstetric care favored the control clusters and maternal infection was likely more common in the intervention clusters.
conclusionsIn this pragmatic trial, limited data were available to identify the causes of the increase in stillbirths in the intervention clusters. A higher rate of stillbirth in the intervention clusters prior to the trial, differences in obstetric care and an increase in maternal infection are potential explanations for the observed increase in stillbirths in the intervention clusters during the trial.
trial registrationclinicaltrials.gov (NCT01084096).
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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.