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المصدر: BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-11 (2021)
مصطلحات موضوعية: Postnatal Care, Adult, Male, medicine.medical_specialty, Referral, Adolescent, Neonatal death, Psychological intervention, Reproductive medicine, Gestational Age, Amhara region, Cohort Studies, Interviews as Topic, Young Adult, Pregnancy, Risk Factors, Infant Mortality, medicine, Humans, Prospective Studies, Prospective cohort study, Obstructed labour, business.industry, Medical record, Incidence (epidemiology), Incidence, Follow-up, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Infant, Gynecology and obstetrics, Middle Aged, medicine.disease, Jaundice, Neonatal, Emergency medicine, RG1-991, Premature Birth, Female, Ethiopia, business
الوصف: Background Addressing sustainable development goals to reduce neonatal mortality remains a global challenge, and it is a concern in Ethiopia. As a result, the goal of this study was to assess the incidence and determinants of neonatal mortality in the first 3 days among babies delivered in the referral hospitals of the Amhara National Regional State. Methods A hospital-based prospective cohort study was conducted among 810 neonates in the first 3 days of delivery between March 1 and August 30, 2018. The neonates were followed up from the time of admission to 72 h. Interviewer-administered questionnaires and medical record reviews were conducted for data collection. Data were entered into Epi-data manager version 4.4 and analysed using STATA™ version 16.0. The neonate’s survival time was calculated using the Cox-Proportional hazards model. Results The overall incidence of neonatal mortality in this study was 151/1000 births. Neonatal mortality was significantly higher among neonates whose mothers came between 17 and 28 weeks of gestation for the first visit; among those whose mothers labour was not monitored with a partograph, mothers experienced postpartum haemorrhage and developed a fistula first 24 h, and experienced obstructed labour. However, 39% were less risky among neonates whose mothers were directly admitted and whose mothers had visited health facilities in less than 1-h, both. Conclusions This study revealed that approximately 1 in 7 neonates died within the first 3 days of life. The determinants were the timing of the first antenatal visit, quality of labour monitoring, maternal complications, and delay in seeking care. Thus, scaling up evidence-based interventions and harmonising efforts to improve antenatal care quality, promote institutional deliveries, provide optimal essential and emergency obstetric care, and ensure immediate postnatal care may improve neonatal survival.
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المؤلفون: Jennifer L. Walsh, Peter McParland, Heather Hughes, Clare O'Connor, Rebecca Moore, Fionnuala M. McAuliffe, Steve Carroll, Shane Higgins, Barbara Cathcart, Rhona Mahony
المصدر: Obstetrical & Gynecological Survey. 77:198-200
مصطلحات موضوعية: Adult, Embryology, Down syndrome, medicine.medical_specialty, Tertiary referral centre, Context (language use), Trisomy, Tertiary Care Centers, Pregnancy, Prenatal Diagnosis, Medicine, Humans, Radiology, Nuclear Medicine and imaging, business.industry, Obstetrics, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, General Medicine, medicine.disease, Natural history, Pediatrics, Perinatology and Child Health, Female, Neonatal death, Outcome data, Down Syndrome, business
الوصف: Objective: The aim of the study was to prospectively gather data on pregnancy outcomes of prenatally diagnosed trisomy 21 (T21) in a large tertiary referral centre. Methods: Data were gathered prospectively in a large tertiary referral centre over 5 years from 2013 to 2017 inclusively. Baseline demographic and pregnancy outcome data were recorded on an anonymized computerized database. Results: There were 1,836 congenital anomalies diagnosed in the study period including 8.9% (n = 165) cases of T21. 79% (n = 131) were age 35 or older at diagnosis. 79/113 (69.9%) women chose a termination of pregnancy (TOP) following a diagnosis of T21. Amongst pregnancies that continued, there were 4 second-trimester miscarriages (4/34, 11.7%), 9 stillbirths (9/34, 26.4%), and 1 neonatal death, giving an overall pregnancy and neonatal loss rate of 14/34 (41.1%). Conclusion: The risk of foetal loss in prenatally diagnosed T21 is high at 38% with an overall pregnancy loss rate of 41.1%. This information may be of benefit when counselling couples who are faced with a diagnosis of T21 particularly in the context of limited access to TOP.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c78f9f4326a9d6427d9c1fbd66d6cb7c
https://doi.org/10.1097/01.ogx.0000827240.10993.5e -
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المؤلفون: Dennis Kalibbala, Jolly Nankunda, Josaphat Byamugisha, Michelle R. Adler, Robert Serunjogi, Doreen Birabwa-Male, Linda Barlow-Mosha, Sarah C. Tinker, Evelyn Nabunya, Diana Valencia, Joyce Namale-Matovu, Philippa Musoke, Daniel Mumpe-Mwanja, Dhelia M. Williamson
المصدر: Reproductive Health, Vol 18, Iss 1, Pp 1-10 (2021)
Reproductive Healthمصطلحات موضوعية: Perinatal Death, Psychological intervention, computer.software_genre, Pregnancy, Prevalence, Birth outcomes, Uganda, Child, Gastroschisis, Sub-Saharan Africa, Database, Age Factors, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, Early neonatal death, Hospital-based surveillance, Hospitals, Pregnancy in Adolescence, Female, medicine.symptom, Infant, Premature, Maternal Age, Adult, medicine.medical_specialty, Adolescent, Reproductive medicine, Mothers, lcsh:Gynecology and obstetrics, Congenital Abnormalities, Young Adult, Obstetric Labor, Premature, Preterm, medicine, Humans, lcsh:RG1-991, Cesarean Section, business.industry, Research, Public health, Infant, Newborn, Infant, Odds ratio, Infant, Low Birth Weight, medicine.disease, Low birth weight, Birth defects, Reproductive Medicine, business, computer
الوصف: Background Uganda has one of the highest adolescent pregnancy rates in sub-Saharan Africa. We compared the risk of adverse birth outcomes between adolescents (age 12–19 years) and mothers (age 20–34 years) in four urban hospitals. Methods Maternal demographics, HIV status, and birth outcomes of all live births, stillbirths, and spontaneous abortions delivered from August 2015 to December 2018 were extracted from a hospital-based birth defects surveillance database. Differences in the distributions of maternal and infant characteristics by maternal age groups were tested with Pearson’s chi-square. Adjusted odds ratios (aORs) and 95% confidence intervals (CI) were calculated using logistic regression to compare the prevalence of adverse birth outcomes among adolescents to mothers 20–34 years. Results A total of 100,189 births were analyzed, with 11.1% among adolescent mothers and 89.0% among older mothers. Adolescent mothers had an increased risk of preterm delivery (aOR: 1.14; CI 1.06–1.23), low birth weight (aOR: 1.46; CI 1.34–1.59), and early neonatal deaths (aOR: 1.58; CI 1.23–2.02). Newborns of adolescent mothers had an increased risk of major external birth defects (aOR: 1.33; CI 1.02–1.76), specifically, gastroschisis (aOR: 3.20; CI 1.12–9.13) compared to mothers 20–34 years. The difference between the prevalence of gastroschisis among adolescent mothers (7.3 per 10,000 births; 95% CI 3.7–14.3) was statistically significant when compared to mothers 20–34 years (1.6 per 10,000 births; 95% CI 0.9–2.6). Conclusions This study found that adolescent mothers had an increased risk for several adverse birth outcomes compared to mothers 20–34 years, similar to findings in the region and globally. Interventions are needed to improve birth outcomes in this vulnerable population.
Plain English Summary Adolescent pregnancies are a global problem occurring in high-, middle-, and low-income countries with Uganda having one of the highest adolescent pregnancy rates in sub-Saharan Africa. We compared the risk of adverse birth outcomes, including major external birth defects, between adolescents, (age 12–19 years) and mothers (age 20–34 years) in four urban hospitals. All informative births, including live births, stillbirths, and spontaneous abortions; regardless of gestational age, delivered at four selected hospitals in Kampala from August 2015 to December 2018 were examined. Demographic data were obtained by midwives through maternal interviews and review of hospital patient notes. Of the 100,189 births, 11.0% were among adolescent mothers and 89.0% among mothers (20–34 years). Adolescent mothers were more likely than mothers (20–34 years) to have an infant with preterm delivery, low birth weight, early neonatal death, and major external birth defects. Adolescent pregnancies were also associated with an increased risk of gastroschisis when compared to mothers (20–34 years). In conclusion, this study found that adolescent mothers had an increased risk for several adverse birth outcomes compared to mothers 20–34 years. Research on the potential underlying causes or mechanisms for these adverse outcomes among adolescent births is necessary to identify possible interventions. -
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المؤلفون: Yu Tong, Qiang Sun, Feng Han, Xiaoguang Shao
المصدر: Ginekologia Polska. 91:600-606
مصطلحات موضوعية: Adult, medicine.medical_specialty, Infant, Newborn, Diseases, law.invention, Primary outcome, Randomized controlled trial, Pregnancy, law, Humans, Medicine, reproductive and urinary physiology, Twin Pregnancy, Fetus, Cesarean Section, business.industry, Vaginal delivery, Obstetrics, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Odds ratio, Delivery, Obstetric, Confidence interval, Elective Surgical Procedures, Pregnancy, Twin, Female, Neonatal death, business
الوصف: Objective: We explored the planned cesarean to vaginal delivery at the risk of fetal or neonatal death or serious neonatal morbidity in women with twin pregnancies. Material and methods: Three hundred and forty-three pregnant women were divided into planned cesarean delivery (PCD) and vaginal delivery (PVD) groups (208 vs 135). In the planned-cesarean-delivery group, the rate of cesarean delivery was 98.82%. Meanwhile, the rate of vaginal delivery was 51.27% in PVD group. Results: Women in the PCD group delivered earlier than that in the PVD group. However, the composite primary outcome of the PCD group was like that of the PVD group. Certainly, the odds ratio of planned cesarean delivery and confidence interval of the PCD group was also like those of the PVD group. Conclusions: The risk of fetal or neonatal death or serious neonatal morbidity of planned-vaginal-delivery was like those of planned-vaginal-delivery in pregnant women with twin pregnancies.
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المؤلفون: Li Ma, Yuan Sun, Xiaohui Guo, Ruilian Zhe, Jun Zhou
المصدر: Journal of Obstetrics and Gynaecology Research. 46:2010-2018
مصطلحات موضوعية: medicine.medical_specialty, Intrauterine growth restriction, 03 medical and health sciences, 0302 clinical medicine, Pre-Eclampsia, Pregnancy, Humans, Medicine, Pregnancy outcomes, Placenta Growth Factor, Homeodomain Proteins, Fetal Growth Retardation, Vascular Endothelial Growth Factor Receptor-1, 030219 obstetrics & reproductive medicine, Receiver operating characteristic, business.industry, Obstetrics, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Prognosis, medicine.disease, Risk evaluation, Distress, Real-time polymerase chain reaction, Case-Control Studies, 030220 oncology & carcinogenesis, embryonic structures, Female, Neonatal death, business, Biomarkers
الوصف: Aim We aimed to explore a new approach and theoretical basis for the diagnosis, treatment and prognosis of pre-eclampsia. Methods In total, 103 pre-eclamptic patients (study group: SG) and 100 healthy pregnant women (control group: CG) were enrolled. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression level of serum Hoxb3. Enzyme-linked immunosorbent assay was used to detect the content of serum sFlt-1. Pregnancy outcomes in the two groups were recorded, and the correlations of the levels of Hoxb3 and sFlt-1 with the pregnancy outcomes were analyzed. Results The relative expression of serum Hoxb3 mRNA in the CG was significantly higher than that in the SG, whereas the content of serum sFlt-1 in the CG was significantly lower than that in the SG. Compared with the CG, the SG had a significantly lower number of spontaneous deliveries, higher number of cesarean deliveries and significantly higher number of uneventful perinatal births. The incidences of intrauterine growth restriction, intrauterine distress, premature infants and neonatal deaths in perinatal infants in the SG were significantly higher than those in the CG. According to the analysis of receiver operating characteristic curves, the areas under the curves of Hoxb3, sFlt-1 and their combined detection for diagnosing pre-eclampsia were 0.799, 0.856 and 0.930, respectively. The areas under the curves for predicting poor perinatal outcomes were 0.724, 0.828 and 0.871, respectively. Conclusion In conclusion, Hoxb3 and sFlt-1 have certain reference significance for the risk evaluation of pre-eclampsia and the adverse pregnancy outcomes of pre-eclampsia women.
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المؤلفون: Yajun Yang, Quan Quan, Qimei Zhong, Shuwei Zhou, Xiaoling Mu, Lan Wang, XiaoYan Zhang, Lingwei Mei
المصدر: Scientific Reports
Scientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)مصطلحات موضوعية: Adult, medicine.medical_specialty, Fetal Membranes, Premature Rupture, Science, Pregnancy Trimester, Third, Twins, Diseases, Gestational Age, macromolecular substances, Logistic regression, Article, Medical research, Pregnancy, medicine, Humans, Perinatal Mortality, Retrospective Studies, Multidisciplinary, Obstetrics, business.industry, Significant difference, Infant, Newborn, Pregnancy Outcome, Gestational age, medicine.disease, Logistic Models, nervous system, Risk factors, Latency stage, Pregnancy, Twin, Medicine, Gestation, Female, Neonatal death, business, Premature rupture of membranes, Infant, Premature, Maternal Age
الوصف: To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity. This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM and compared between PPROM and non PPROM twins. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis. Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. There was no significant difference in general neonatal outcomes between PPROM and non PPROM twins. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score
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المؤلفون: Alfazal Khan, Tahmeed Ahmed, S. M. Tafsir Hasan
المصدر: International Journal of Environmental Research and Public Health
Volume 18
Issue 12
International Journal of Environmental Research and Public Health, Vol 18, Iss 6519, p 6519 (2021)مصطلحات موضوعية: medicine.medical_specialty, Health, Toxicology and Mutagenesis, Institute of medicine, Article, Odds, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, cesarean delivery, medicine, Humans, 030212 general & internal medicine, large for gestational age (LGA), Cesarean delivery, Retrospective Studies, rate of weight gain in the second and third trimester, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Pregnancy, Bangladesh, neonatal death, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, Public Health, Environmental and Occupational Health, Infant, Newborn, Pregnancy Outcome, preterm birth, Odds ratio, medicine.disease, Gestational Weight Gain, United States, Institute of Medicine (IOM), Pregnancy Complications, Low birth weight, Medicine, Gestation, Premature Birth, small for gestational age (SGA), Female, pregnancy, medicine.symptom, business, gestational weight gain (GWG), Weight gain
الوصف: Although validated in other parts of the world, the suitability of the U.S. Institute of Medicine (IOM) 2009 recommendations on gestational weight gain (GWG) for Bangladeshi women remains to be examined. We evaluated the association between the weekly rate of weight gain during the second and third trimester of pregnancy, categorized according to IOM recommendations, and adverse perinatal outcomes among 1569 pregnant women with singleton live births in rural Matlab, Bangladesh. Gaining weight at rates below the IOM recommendations was associated with higher odds of preterm birth (adjusted odds ratio (AOR) = 2.0, 95% CI: 1.1–3.6), low birth weight (AOR = 1.4, 95% CI: 1.03–2.0), small-for-gestational-age newborns (AOR = 1.3, 95% CI: 1.04–1.7), and poor neonatal outcome (severe neonatal morbidity or death, AOR = 2.4, 95% CI: 1.03–5.6). A GWG rate above the recommendations was associated with higher odds of cesarean delivery (AOR = 1.7, 95% CI: 1.1–2.6), preterm birth (AOR = 2.2, 95% CI: 1.1–4.4), large-for-gestational-age newborns (AOR = 5.9, 95% CI: 1.5–23.1), and poor neonatal outcome (AOR = 2.7, 95% CI: 1.04–7.0). Our results suggest that the IOM 2009 recommendations on GWG rate during the second and third trimester may be suitable for guiding rural Bangladeshi women in the prenatal period, although the women should aim for rates near the lower bound of the range.
وصف الملف: application/pdf
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المؤلفون: Laura Schummers, Vivienne Souter, Audrey Levine, Aaron B Caughey, Elizabeth Nethery, Wendy Gordon
المصدر: Obstetrics and Gynecology
مصطلحات موضوعية: Adult, Washington, medicine.medical_specialty, Perinatal Death, education, Midwifery, Birthing Centers, Cohort Studies, Young Adult, Pregnancy, medicine, Humans, health care economics and organizations, Perinatal Mortality, Home Childbirth, Retrospective Studies, Original Research, Obstetrics, Perinatal mortality, business.industry, Cesarean Section, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Retrospective cohort study, Place of birth, Delivery, Obstetric, Parity, Perinatal Care, Relative risk, Cohort, Population study, Female, Contents, Neonatal death, Parity (mathematics), business
الوصف: Risks of adverse outcomes in planned home and birth center births were similar; overall, perinatal outcomes were comparable with international settings.
OBJECTIVE: To describe rates of maternal and perinatal birth outcomes for community births and to compare outcomes by planned place of birth (home vs state-licensed, freestanding birth center) in a Washington State birth cohort, where midwifery practice and integration mirrors international settings. METHODS: We conducted a retrospective cohort study including all births attended by members of a statewide midwifery professional association that were within professional association guidelines and met eligibility criteria for planned birth center birth (term gestation, singleton, vertex fetus with no known fluid abnormalities at term, no prior cesarean birth, no hypertensive disorders, no prepregnancy diabetes), from January 1, 2015 through June 30, 2020. Outcome rates were calculated for all planned community births in the cohort. Estimated relative risks were calculated comparing delivery and perinatal outcomes for planned births at home to state-licensed birth centers, adjusted for parity and other confounders. RESULTS: The study population included 10,609 births: 40.9% planned home and 59.1% planned birth center births. Intrapartum transfers to hospital were more frequent among nulliparous individuals (30.5%; 95% CI 29.2–31.9) than multiparous individuals (4.2%; 95% CI 3.6–4.6). The cesarean delivery rate was 11.4% (95% CI 10.2–12.3) in nulliparous individuals and 0.87% (95% CI 0.7–1.1) in multiparous individuals. The perinatal mortality rate after the onset of labor (intrapartum and neonatal deaths through 7 days) was 0.57 (95% CI 0.19–1.04) per 1,000 births. Rates for other adverse outcomes were also low. Compared with planned birth center births, planned home births had similar risks in crude and adjusted analyses. CONCLUSION: Rates of adverse outcomes for this cohort in a U.S. state with well-established and integrated community midwifery were low overall. Birth outcomes were similar for births planned at home or at a state-licensed, freestanding birth center.URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::369f112a08fe0fd1877ccf11bceda1a2
https://pubmed.ncbi.nlm.nih.gov/34619716 -
9Maternal and perinatal outcomes related to COVID‐19 and pregnancy: An overview of systematic reviews
المؤلفون: Vergara‐Merino, Laura, Meza, Nicolás, Couve‐Pérez, Constanza, Carrasco, Cynthia, Ortiz‐Muñoz, Luis, Madrid, Eva, Bohorquez‐Blanco, Sandra, Pérez‐Bracchiglione, Javier
المصدر: Acta Obstetricia et Gynecologica Scandinavica
مصطلحات موضوعية: medicine.medical_specialty, Systematic Reviews, Coronavirus disease 2019 (COVID-19), Overview, MEDLINE, Pregnancy, COVID‐19, Intensive care, Obstetrics and Gynaecology, medicine, Humans, Pregnancy Complications, Infectious, business.industry, Infant, Newborn, Pregnancy Outcome, COVID-19, Infant, Obstetrics and Gynecology, General Medicine, Newborn, medicine.disease, Clinical trial, Systematic review, Family medicine, Female, Maternal death, Systematic Review, Pregnant Women, Neonatal death, Coronavirus Infections, business, Systematic Reviews as Topic
الوصف: Evidence about coronavirus disease 2019 (COVID-19) and pregnancy has rapidly increased since December 2019, making it difficult to make rigorous evidence-based decisions. The objective of this overview of systematic reviews is to conduct a comprehensive analysis of the current evidence on prognosis of COVID-19 in pregnant women.We used the Living OVerview of Evidence (L·OVE) platform for COVID-19, which continually retrieves studies from 46 data sources (including PubMed/MEDLINE, Embase, other electronic databases, clinical trials registries, and preprint repositories, among other sources relevant to COVID-19), mapping them into PICO (population, intervention, control, and outcomes) questions. The search covered the period from the inception date of each database to 13 September 2020. We included systematic reviews assessing outcomes of pregnant women with COVID-19 and/or their newborns. Two authors independently screened the titles and abstracts, assessed full texts to select the studies that met the inclusion criteria, extracted data, and appraised the risk of bias of each included systematic review. We measured the overlap of primary studies included among the selected systematic reviews by building a matrix of evidence, calculating the corrected covered area, and assessing the level of overlap for every pair of systematic reviews.Our search yielded 1132 references. 52 systematic reviews met inclusion criteria and were included in this overview. Only one review had a low risk of bias, three had an unclear risk of bias, and 48 had a high risk of bias. Most of the included reviews were highly overlapped among each other. In the included reviews, rates of maternal death varied from 0% to 11.1%, admission to intensive care from 2.1% to 28.5%, preterm deliveries before 37 weeks from 14.3% to 61.2%, and cesarean delivery from 48.3% to 100%. Regarding neonatal outcomes, neonatal death varied from 0% to 11.7% and the estimated infection status of the newborn varied between 0% and 11.5%.Only one of 52 systematic reviews had a low risk of bias. Results were heterogeneous and the overlap of primary studies was frequently very high between pairs of systematic reviews. High-quality evidence syntheses of comparative studies are needed to guide future clinical decisions.
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المؤلفون: Smaragda Lamprianou, Patrick L.F. Zuber, Hugo Devlieger, Margarita Riera, Thomas Verstraeten, Silvia Perez-Vilar, Steven A. Anderson, Christine Maure, Punam Mangtani, Anke L. Stuurman
المصدر: Vaccine. 36:6736-6743
مصطلحات موضوعية: Vaccine safety, medicine.medical_specialty, 030231 tropical medicine, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Bloodstream infection, medicine, Humans, 030212 general & internal medicine, Retrospective Studies, Vaccines, General Veterinary, General Immunology and Microbiology, business.industry, Pregnancy Outcome, Public Health, Environmental and Occupational Health, Preterm Births, medicine.disease, Vaccination, Infectious Diseases, Low and middle income countries, Family medicine, Molecular Medicine, Female, Immunization, Intrapartum Stillbirth, Neonatal death, business
الوصف: Background Global efforts to adequately monitor safety of new vaccines for pregnant women in low and middle-income countries (LMICs) are needed. The Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) project recently published case definitions based on levels of diagnostic certainty for pregnancy- and neonatal outcomes and maternal vaccination. As a preliminary step to assessing the applicability of these definitions in LMICs, WHO selected sites and conducted a feasibility assessment to evaluate their ability to identify and classify selected outcomes (preterm birth, neonatal death, neonatal invasive bloodstream infection (NI-BSI), stillbirth) and maternal vaccination. Methods Candidate sites were initially screened using a questionnaire. For each outcome, eligible sites were asked to retrospectively identify and collect information for three individuals born in 2016. Subsequently, outcomes were classified by level of diagnostic certainty. Results Fifty-one sites (15 countries) were screened; 32 of them (9 countries) participated in the assessment and identified 315 subjects with the outcomes of interest. Twenty-four sites (8 countries) identified at least one subject per outcome and agreed to continue participating. The majority (80%) of preterm births, neonatal deaths, and NI-BSI subjects, but only 50% of stillbirths, could be assessed for diagnostic certainty. The main reasons for not classifying stillbirths were insufficient information to distinguish between antepartum and intrapartum stillbirth (29%); or that not all data for one subject fit into a single level of diagnostic certainty (35%). Forty-nine percent of mothers were considered vaccinated, 6% not-vaccinated, and vaccination status could not be assessed in 44% of them. Discussion GAIA case definitions for four neonatal outcomes and maternal vaccination were successfully piloted in 24 sentinel sites across four WHO regions. Our assessment found that modification of the stillbirth definition could help avoid potential misclassification. Vaccine safety monitoring in LMICs will benefit from systematic recording of all vaccinations during pregnancy.
وصف الملف: application/pdf
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