Evidence map›Paper›PMID 36777885›Full record

ArticleLancet regional health. Americas2022

Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017.

María Elena Critto, Yordanis Enriquez, Miguel Bravo, Lenin de Janon Quevedo, Ruth Weinberg, Adolfo Etchegaray, Elard S Koch

Abstract read
In one paragraph

Article in Lancet regional health. Americas, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

7 authors.

María Elena CrittoDivision of Epidemiology, MELISA Institute, Concepción, Chile.
Yordanis EnriquezFacultad de Ciencias de la Salud, Universidad Católica Sedes Sapientiae, Lima, Perú.
Miguel BravoDivision of Epidemiology, MELISA Institute, Concepción, Chile.
Lenin de Janon QuevedoFacultad de Ciencias Médicas, Pontificia Universidad Católica de Argentina, Ciudad de Buenos Aires, Argentina.
Ruth WeinbergFacultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
Adolfo EtchegarayHospital Universitario Austral, Facultad de Medicina, Universidad Austral, Buenos Aires, Argentina.
Elard S KochDivision of Epidemiology, MELISA Institute, Concepción, Chile.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Emerging pandemic viruses may have multiple deleterious effects on maternal health. This study examines the effects of a pandemic influenza virus on cause-specific maternal mortality time series, using Argentinian vital statistics. Methods: We conducted a population-based natural experiment from national vital records of maternal deaths between 1980 and 2017. Joinpoint regression models were used to model time series of the maternal mortality ratio (MMR). The sensitivity of the registry to detect the effects of the pandemic H1N1 2009 influenza virus on cause-specific MMR was analysed using a panel of parallel interrupted time series (ITS). Findings: Over this 38-year study, the MMR decreased by 58·6% (69·5 to 28·8 deaths/100,000 live births), transitioning from direct obstetric causes (67·0 to 21·1/100,000 live births; 68·4% decrease) to indirect causes (2·6 to 7·7/100,000 live births; 196·2% increase). The regression analysis showed an average reduction of -2·2%/year (95% CI: -2·9 to -1·4) with 2 join points in the total trend (1998 and 2009). Parallel ITS analyses revealed the pandemic H1N1 virus had an increasing effect on mortality from the respiratory system- and sepsis-related complications (level change 4·7 and 1·6/100,000 live births respectively), reversing after the outbreak. No effect was found on MMR from hypertensive disorders, haemorrhage, abortive outcomes, other direct obstetric causes, and indirect non-respiratory comorbidities. Interpretation: The Argentinian maternal death registry appears sensitive to detect different effects of emerging infectious epidemics on maternal health. In a population-based natural experiment, pandemic H1N1 virus impacted maternal mortality almost exclusively from the respiratory system- and sepsis-related complications. Funding: Supported by FISAR www.fisarchile.org.

Indexed as

AAPC, average annual percentage changeA[H1N1]pmd09, H1N1 pandemic A influenza virus 2009APC, annual percentage changeArgentinaH1N1 VirusICD, International Classification of DiseasesInterrupted Time Series AnalysisITS, Interrupted Time SeriesMaternal MortalityMMR, maternal mortality ratioPandemicsPublic Health SurveillanceWHO, World Health Organization

Identifiers

PMID36777885
PMCPMC9904057

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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.