Evidence map›Paper›PMID 37120529›Full record

SynthesisBMC pregnancy and childbirth2023

Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: a systematic review.

Nicola E Symonds, Marianne Vidler, Matthew O Wiens, Shazmeen Omar, L Lacey English, U Vivian Ukah, J Mark Ansermino, Joseph Ngonzi, Lisa M Bebell, Bella Hwang and 3 more

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
11.0field-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.

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

16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Observational
  4. Review
  5. Observational
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. 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

13 authors at 6 institutions in 3 countries.

Nicola E SymondsThe Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.
Marianne VidlerDepartment of Obstetrics and Gynaecology, University of British Columbia, Rm V3-339, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada. marianne.vidler@cw.bc.ca.
Matthew O WiensDepartment of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Shazmeen OmarDepartment of Obstetrics and Gynaecology, University of British Columbia, Rm V3-339, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
L Lacey EnglishDepartment of Internal Medicine and Pediatrics, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
U Vivian UkahDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
J Mark AnserminoThe Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.
Joseph NgonziDepartment of Obstetrics and Gynaecology, Mbarara University of Science and Technology, Mbarara, Uganda.
Lisa M BebellInfectious Diseases Division, and Center for Global Health, Massachusetts General Hospital Medical Practice Evaluation Center, Boston, MA, USA.
Bella HwangThe Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.
Astrid Christoffersen-DebDepartment of Obstetrics and Gynaecology, University of British Columbia, Rm V3-339, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
Niranjan KissoonThe Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.
Beth A PayneSchool of Public and Population Health, University of British Columbia, Vancouver, BC, Canada.
BC Children's Hospital · CAUniversity of British Columbia · CAMbarara University of Science and Technology · UGHospital of the University of Pennsylvania · USMassachusetts General Hospital · USMcGill University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn low- and middle-income countries, approximately two thirds of maternal deaths occur in the postpartum period. Yet, care for women beyond 24 h after discharge is limited. The objective of this systematic review is to summarize current evidence on socio-demographic and clinical risk factors for (1) postpartum mortality and (2) postpartum hospital readmission.

methodsA combination of keywords and subject headings (i.e. MeSH terms) for postpartum maternal mortality or readmission were searched. Articles published up to January 9, 2021 were identified in MEDLINE, EMBASE, and CINAHL databases, without language restrictions. Studies reporting socio-demographic or clinical risk factors for postpartum mortality or readmission within six weeks of delivery among women who delivered a livebirth in a low- or middle-income country were included. Data were extracted independently by two reviewers based on study characteristics, population, and outcomes. Included studies were assessed for quality and risk of bias using the Downs and Black checklist for ratings of randomized and non-randomized studies.

resultsOf 8783 abstracts screened, seven studies were included (total N = 387,786). Risk factors for postpartum mortality included Caesarean mode of delivery, nulliparity, low or very low birthweight, and shock upon admission. Risk factors for postpartum readmission included Caesarean mode of delivery, HIV positive serostatus, and abnormal body temperature.

conclusionsFew studies reported individual socio-demographic or clinical risk factors for mortality or readmission after delivery in low- and middle-income countries; only Caesarean delivery was consistently reported. Further research is needed to identify factors that put women at greatest risk of post-discharge complications and mortality. Understanding post-discharge risk would facilitate targeted postpartum care and reduce adverse outcomes in women after delivery.

trial registrationPROSPERO registration number: CRD42018103955.

Indexed as

AftercarePatient ReadmissionDeveloping CountriesFemaleHumansMaternal MortalityPatient DischargePostpartum PeriodPregnancyRisk FactorsLow- and middle-income countriesMaternal mortalityPost-discharge riskPostpartum periodReadmission

Identifiers

PMID37120529
PMCPMC10148415
OpenAlexW4367368203

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.