Evidence map›Paper›PMID 28927395›Full record

ArticleBMC pregnancy and childbirth2017

Detection and risk stratification of women at high risk of preterm birth in rural communities near Nagpur, India.

Archana Patel, Amber Abhijeet Prakash, Yamini V Pusdekar, Hemant Kulkarni, Patricia Hibberd

2 registry-linked trialsOpen access · goldAbstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 22% 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.

NCT01073475 recruitingnot on this map

Global Network for Women's and Children's Health Research Maternal Newborn Health Registry

TypeobservationalSponsorNICHD Global Network for Women's and Children's HealthRan2008 to 2030Enrolled950,000ConditionsPregnancy Outcome Trends in Low-resource Geographic AreasArmsThere is no intervention associated with the parent MNHR study. For the MNHR COVID sub-study, participants will be asked to provide a blood specimen at or near delivery.
NCT01084096 nacompletednot on this map

Trial of the Use of Antenatal Corticosteroids in Developing Countries

TypeinterventionalSponsorNICHD Global Network for Women's and Children's HealthRan2011 to 2014Enrolled103,117ConditionsPreterm BirthArmsIncreasing use of Antenatal Corticosteroids (ACS)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Assessing the Respiratory Effects of Air Pollution from Biomass Cookstoves on Pregnant Women in Rural India.International journal of environmental research and public health · 2020
    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

5 authors at 3 institutions in 2 countries.

Archana PatelLata Medical Research Foundation, Nagpur, India. dr_apatel@yahoo.com.
Amber Abhijeet PrakashLata Medical Research Foundation, Nagpur, India.
Yamini V PusdekarLata Medical Research Foundation, Nagpur, India.
Hemant KulkarniLata Medical Research Foundation, Nagpur, India.
Patricia HibberdDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.
Lata Medical Research Foundation · INBoston University · USThe University of Texas Rio Grande Valley · US

Funding

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
Improving Quality of Care for the Treatment of Childhood PneumoniaU01HD058322 · NICHD · TUFTS UNIVERSITY BOSTON · PI HIBBERD, PATRICIA L · 2008 to 2012
$4.0M
Maternal and Child Health Benefits from Reducing Household Air PollutionU10HD078439 · NICHD · MASSACHUSETTS GENERAL HOSPITAL · PI HIBBERD, PATRICIA L · 2013 to 2017
$3.1M
Midcareer Investigator Award in Patient-Oriented Research (K24)K24AT003683 · NCCIH · TUFTS MEDICAL CENTER · PI HIBBERD, PATRICIA L · 2006 to 2015
$1.9M
NCCIH NIH HHS K24 AT003683NICHD NIH HHS U01 HD058322NICHD NIH HHS U10 HD078439NICHD NIH HHS UG1 HD078439
6 · The paper itself

Abstract

backgroundPresently, preterm birth is globally the leading cause of neonatal mortality. Prompt community based identification of women at high risk for preterm births (HRPB) can either help to avert preterm births or avail effective interventions to reduce neonatal mortality due to preterm births. We evaluated the performance of a package to train community workers to detect the presence of signs or symptoms of HRPB.

methodsPregnant women enrolled in the intervention arm of a cluster randomized trial of Antenatal Corticosteroids (ACT Trial) conducted at Nagpur, India were informed about 4 directly observable signs and symptoms of preterm labor. Community health workers actively monitored these women from 24 to 36 weeks of gestation for these signs or symptoms. If they were present (HRPB positive) the identified women were brought to government health facilities for assessment and management. HRPB positive could also be determined by the provider if the woman presented directly to the facility. Risk stratification was based on the number of signs or symptoms present. The outcome of preterm birth was based on the clinical assessment of gestational age < 37 weeks at delivery or a birth weight of <2000 g.

resultsBetween July 1, 2012 and 30 November, 2013, 686 of 7050 (9.7%) pregnant women studied, delivered preterm. 732 (10.4%) women were HRPB positive, of whom 333 (45.5%) delivered preterm. Of the remaining 6318(89.6%) HRPB negative women 353 (5.6%) delivered preterm. The likelihood ratio (LR) of a preterm birth in the HRPB positives was 8.14 (95% confidence interval 7.16-9.26). The LR of a preterm birth increased in women who had more signs or symptoms of HRBP (p < 0.00001). More signs or symptoms of HRPB were also associated with a shorter time to delivery, lower birth weight and higher rates of stillbirths, neonatal deaths and postnatal complications. Addition of risk stratification improved the prediction of preterm delivery (Integrated Discrimination Improvement 17% (95% CI 15-19%)).

conclusionsThe package for detection of signs and symptoms of HRPB is feasible, promising and likely to improve management of preterm labor.

trial registrationNCT01073475 on February 21, 2010 and NCT01084096 on March 9, 2010.

Indexed as

Risk AssessmentRural PopulationAdultBirth WeightCohort StudiesCommunity Health WorkersFemaleHumansIndiaObstetric Labor, PrematurePerinatal DeathPregnancyPremature BirthProspective StudiesStillbirthTime FactorsCommunity workersDiagnostic accuracyPreterm birthRisk stratification

Identifiers

PMID28927395
PMCPMC5606131
OpenAlexW2753937516

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.