Evidence map›Paper›PMID 28139875›Full record

Observational studyBJOG : an international journal of obstetrics and gynaecology2018

Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system.

E M McClure, A Garces, S Saleem, J L Moore, C L Bose, F Esamai, S S Goudar, E Chomba, M Mwenechanya, O Pasha and 18 more

Registry-linked trialOpen access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BJOG : an international journal of obstetrics and gynaecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03438110 (Project to Understand & Research Preterm Pregnancy Outcomes-South Asia), which is not on this map. Cited by 40 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 2 pooled it
11.8field-weighted citation impact, top 2% of its field
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.

NCT03438110 completednot on this map

Project to Understand & Research Preterm Pregnancy Outcomes-South Asia (PURPOSe)

TypeobservationalSponsorRTI InternationalRan2018 to 2020Enrolled1,226ConditionsNeonatal Death, Stillbirth
3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.

  1. Pooled it
  2. Interventions for investigating and identifying the causes of stillbirth.The Cochrane database of systematic reviews · 2018
    Pooled it
  3. Trial
  4. Anti-hypertensive use for non-severe gestational hypertension in Botswana: A case-control study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022
    Trial
  5. Article
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  14. Review
  15. Article
  16. Pregnancy and diabetic ketoacidosis: fetal jeopardy and windows of opportunity.Frontiers in clinical diabetes and healthcare · 2023
    Article
  17. Article
  18. Article
  19. Article
  20. Methodology to Determine Cause of Death for Stillbirths and Neonatal Deaths Using Automated Case Reports and a Cause-of-Death Panel.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors at 16 institutions in 7 countries.

E M McClureRTI International, Durham, NC, USA.
A GarcesMaterno Infantil Unidad de Planificación, INCAP, Guatemala City, Guatemala.
S SaleemDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
J L MooreRTI International, Durham, NC, USA.
C L BoseDepartment of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
F EsamaiDepartment of Paediatrics, Moi University College of Health and Sciences, Eldoret, Kenya.
S S GoudarKLE University's JN Medical College, Belagavi, India.
E ChombaDepartment of Paediatrics, University of Zambia, Lusaka, Zambia.
M MwenechanyaDepartment of Paediatrics, University of Zambia, Lusaka, Zambia.
O PashaDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
A TshefuKinshasa School of Public Health, Kinshasa, DRC.
A PatelLata Medical Research Foundation, Nagpur, India.
S M DhadedKLE University's JN Medical College, Belagavi, India.
C TengeDepartment of Paediatrics, Moi University College of Health and Sciences, Eldoret, Kenya.
I MareteDepartment of Paediatrics, Moi University College of Health and Sciences, Eldoret, Kenya.
M BausermanDepartment of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
S SunderDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
B S KodkanyKLE University's JN Medical College, Belagavi, India.
W A CarloDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
R J DermanDepartment of Obstetrics, Thomas Jefferson University, Philadelphia, PA, USA.
P L HibberdBoston University, Boston, MA, USA.
E A LiechtyDepartment of Pediatrics, Indiana University, Indianapolis, IN, USA.
K M HambidgeDepartment of Pediatrics, University of Colorado, Denver, CO, USA.
N F KrebsDepartment of Pediatrics, University of Colorado, Denver, CO, USA.
M Koso-ThomasPerinatology and Pregnancy Branch, NICHD, Bethesda, MD, USA.
M MiodovnikPerinatology and Pregnancy Branch, NICHD, Bethesda, MD, USA.
D D WallaceRTI International, Durham, NC, USA.
R L GoldenbergColumbia University Medical Center, New York, NY, USA.
Aga Khan University · PKKLE University · INMoi University · KERTI International · USEunice Kennedy Shriver National Institute of Child Health and Human Development · USUniversity of Colorado Denver · USUniversity of North Carolina at Chapel Hill · USUniversity of Zambia · ZMBoston University · USColumbia University Irving Medical Center · USIndiana University – Purdue University Indianapolis · USInstitute of Nutrition of Central America and Panama · GTLata Medical Research Foundation · INMinistry of Public Health · CDThomas Jefferson University · USUniversity of Alabama at Birmingham · US

Funding

Zika in Pregnancy Supplemental Funding requestU01HD040636 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI MCCLURE, ELIZABETH M · 2001 to 2017
$37.5M
Global Network for Women's and Children's Health Research Data Coordinating CenterU24HD092094 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI Elizabeth M McClure · 2017 to 2026
$17.8M
UAB/AKU Global Network Research UnitU01HD040607 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GOLDENBERG, ROBERT L · 2001 to 2012
$8.5M
Complementary feeding: a Global Network cluster randomized controlled trialU01HD040657 · NICHD · UNIVERSITY OF COLORADO DENVER · PI HAMBIDGE, K MICHAEL · 2001 to 2012
$8.1M
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
The University of North Carolina-Kinshasa School of Public Health Research Partnership in the Democratic Republic of Congo; a Model for Improving Women'sand Children's Health Through ResearchUG1HD076465 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MELISSA SCHWEIKHART BAUSERMAN · 2018 to 2026
$5.6M
Boston University/Lata Medical Research Foundation Global Network for Women's Children's Health Research UnitUG1HD078439 · NICHD · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Patricia L Hibberd · 2018 to 2026
$5.5M
TJU-JNMC Global Network for Women's & Children's Health Research UnitUG1HD076457 · NICHD · THOMAS JEFFERSON UNIVERSITY · PI RICHARD J DERMAN · 2018 to 2026
$5.5M
Nutrition-specific interventions to improve long-term maternal-child health outcomesUG1HD076474 · NICHD · UNIVERSITY OF COLORADO DENVER · PI Edwin Jose Asturias, NANCY F KREBS · 2018 to 2026
$5.4M
The Global Network and Preconception Maternal NutritionU10HD076474 · NICHD · UNIVERSITY OF COLORADO DENVER · PI HAMBIDGE, K MICHAEL, KREBS, NANCY F · 2013 to 2017
$5.1M
NCCIH NIH HHS K24 AT003683NICHD NIH HHS U01 HD040477NICHD NIH HHS U01 HD040607NICHD NIH HHS U01 HD040636NICHD NIH HHS U01 HD040657NICHD NIH HHS U01 HD042372NICHD NIH HHS U01 HD043464NICHD NIH HHS U01 HD058322NICHD NIH HHS U01 HD058326NICHD NIH HHS U10 HD076457NICHD NIH HHS U10 HD076474NICHD NIH HHS U10 HD078437NICHD NIH HHS U10 HD078438NICHD NIH HHS U10 HD078439NICHD NIH HHS U24 HD092094NICHD NIH HHS UG1 HD076457NICHD NIH HHS UG1 HD076465NICHD NIH HHS UG1 HD076474NICHD NIH HHS UG1 HD078439
6 · The paper itself

Abstract

objectiveWe sought to classify causes of stillbirth for six low-middle-income countries using a prospectively defined algorithm.

designProspective, observational study.

settingCommunities in India, Pakistan, Guatemala, Democratic Republic of Congo, Zambia and Kenya. POPULATION: Pregnant women residing in defined study regions.

methodsBasic data regarding conditions present during pregnancy and delivery were collected. Using these data, a computer-based hierarchal algorithm assigned cause of stillbirth. Causes included birth trauma, congenital anomaly, infection, asphyxia, and preterm birth, based on existing cause of death classifications and included contributing maternal conditions.

main outcome measuresPrimary cause of stillbirth.

resultsOf 109 911 women who were enrolled and delivered (99% of those screened in pregnancy), 2847 had a stillbirth (a rate of 27.2 per 1000 births). Asphyxia was the cause of 46.6% of the stillbirths, followed by infection (20.8%), congenital anomalies (8.4%) and prematurity (6.6%). Among those caused by asphyxia, 38% had prolonged or obstructed labour, 19% antepartum haemorrhage and 18% pre-eclampsia/eclampsia. About two-thirds (67.4%) of the stillbirths did not have signs of maceration.

conclusionsOur algorithm determined cause of stillbirth from basic data obtained from lay-health providers. The major cause of stillbirth was fetal asphyxia associated with prolonged or obstructed labour, pre-eclampsia and antepartum haemorrhage. In the African sites, infection also was an important contributor to stillbirth. Using this algorithm, we documented cause of stillbirth and its trends to inform public health programs, using consistency, transparency, and comparability across time or regions with minimal burden on the healthcare system. TWEETABLE ABSTRACT: Major causes of stillbirth are asphyxia, pre-eclampsia and haemorrhage. Infections are important in Africa.

Indexed as

AlgorithmsRegistriesAfricaAsiaDeveloping CountriesFemaleGlobal HealthGuatemalaHumansMaternal-Child Health ServicesPregnancyPregnancy ComplicationsProspective StudiesStillbirthCause of death classification systemlow-income countriesstillbirth

Identifiers

PMID28139875
PMCPMC5537043
OpenAlexW2584287847

What OpenQuestion holds

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Registered trials

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.