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Full-Text Articles in Medicine and Health Sciences
Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg
Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg
Community Health Sciences
Background: While the relationship between hemoglobin (Hb) concentrations and pregnancy outcomes has been studied often, most reports have focused on a specific Hb cutoff used to define anemia. Fewer studies have evaluated pregnancy outcomes across the entire range of Hb values. Moreover, to date, most studies of the relationship of Hb concentrations to pregnancy outcomes have been done in high-income countries. Thus, we have sought to determine the relationship between the range of maternal Hb concentrations and adverse birth outcomes among South Asian pregnant women.
Methods: For this study, we used data collected from two South Asian countries (Pakistan - …
Stillbirth 2010-2018: A Prospective, Population-Based, Multi-Country Study From The Global Network, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Gouda, Ana Garces, Ryan Whitworth, Fabian Esamai, Archana B. Patel, Shiyam Sunder Tikmani, Musaku Mwenechanya, Elwyn Chomba
Stillbirth 2010-2018: A Prospective, Population-Based, Multi-Country Study From The Global Network, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Gouda, Ana Garces, Ryan Whitworth, Fabian Esamai, Archana B. Patel, Shiyam Sunder Tikmani, Musaku Mwenechanya, Elwyn Chomba
Community Health Sciences
Background: Stillbirth rates are high and represent a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC). In LMIC, where nearly 98% of stillbirths worldwide occur, few population-based studies have documented cause of stillbirths or the trends in rate of stillbirth over time.
Methods: We undertook a prospective, population-based multi-country research study of all pregnant women in defined geographic areas across 7 sites in low-resource settings (Kenya, Zambia, Democratic Republic of Congo, India, Pakistan, and Guatemala). Staff collected demographic and health care characteristics with outcomes obtained at delivery. Cause of stillbirth was assigned by algorithm.
Results: From …
Predictive Modeling For Perinatal Mortality In Resource-Limited Settings, Vivek V. Shukla, Barry Eggleston, Namasivayam Ambalavanan, Elizabeth M. Mcclure, Musaku Mwenechanya, Elwyn Chomba, Carl Bose, Melissa Bauserman, Antoinette Tshefu, Sarah Saleem
Predictive Modeling For Perinatal Mortality In Resource-Limited Settings, Vivek V. Shukla, Barry Eggleston, Namasivayam Ambalavanan, Elizabeth M. Mcclure, Musaku Mwenechanya, Elwyn Chomba, Carl Bose, Melissa Bauserman, Antoinette Tshefu, Sarah Saleem
Community Health Sciences
Importance: The overwhelming majority of fetal and neonatal deaths occur in low- and middle-income countries. Fetal and neonatal risk assessment tools may be useful to predict the risk of death.
Objective: To develop risk prediction models for intrapartum stillbirth and neonatal death.
Design, setting, and participants: This cohort study used data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Global Network for Women's and Children's Health Research population-based vital registry, including clinical sites in South Asia (India and Pakistan), Africa (Democratic Republic of Congo, Zambia, and Kenya), and Latin America (Guatemala). A total of 502 …
Perceptions Of Health Professionals Regarding Minimally Invasive Tissue Sampling (Mits) To Identify The Cause Of Death In Stillbirths And Neonates: Results From A Qualitative Study, Anam Shahil Feroz, Anum Shiraz Ali, Mohsina Noor Ibrahim, Elizabeth M. Mcclure, Shiyam Sunder Tikmani, Sayyeda Reza, Zahid Abbasi, Afia Zafar, Sameen Siddiqi, Sarah Saleem
Perceptions Of Health Professionals Regarding Minimally Invasive Tissue Sampling (Mits) To Identify The Cause Of Death In Stillbirths And Neonates: Results From A Qualitative Study, Anam Shahil Feroz, Anum Shiraz Ali, Mohsina Noor Ibrahim, Elizabeth M. Mcclure, Shiyam Sunder Tikmani, Sayyeda Reza, Zahid Abbasi, Afia Zafar, Sameen Siddiqi, Sarah Saleem
Community Health Sciences
Background: Pakistan is considered to be one of the riskiest places in the world for childbirth as measured by its high stillbirth and neonatal mortality rates. Complete diagnostic autopsy remains the gold standard to determine the cause of death (CoD); however, it is not routinely implemented due to religious objections, sociocultural beliefs, limited resources and low demand from physicians and families. Recently, minimally invasive tissue sampling (MITS) using needle biopsies of multiple tissues to obtain tissue for histological examination and organism identification with PCR has been developed and promoted to determine CoD in low-resource areas. To ensure successful implementation of …
Perceptions Of Parents And Religious Leaders Regarding Minimal Invasive Tissue Sampling To Identify The Cause Of Death In Stillbirths And Neonates: Results From A Qualitative Study, Anam Shahil Feroz, Mohsina Noor Ibrahim, Elizabeth M. Mcclure, Anum Shiraz Ali, Shiyam Sunder Tikmani, Sayyeda Reza, Zahid Abbasi, Jamal Raza, Haleema Yasmin, Khadija Bano, Afia Zafar, Sameen Siddiqi, Robert L. Goldenberg, Sarah Saleem
Perceptions Of Parents And Religious Leaders Regarding Minimal Invasive Tissue Sampling To Identify The Cause Of Death In Stillbirths And Neonates: Results From A Qualitative Study, Anam Shahil Feroz, Mohsina Noor Ibrahim, Elizabeth M. Mcclure, Anum Shiraz Ali, Shiyam Sunder Tikmani, Sayyeda Reza, Zahid Abbasi, Jamal Raza, Haleema Yasmin, Khadija Bano, Afia Zafar, Sameen Siddiqi, Robert L. Goldenberg, Sarah Saleem
Community Health Sciences
Background: Recently, the minimal invasive tissue sampling (MITS) procedure has been developed to support determination of the cause of death as an alternate to conventional autopsy, especially in countries where complete diagnostic autopsy is not routine. To assess the feasibility of implementation of the MITS procedure for a study to determine cause of death in premature births and stillbirths in south Asia, we explored the views and perceptions of parents and religious leaders on the acceptability of MITS.
Methods: A qualitative study was conducted at the National Institute of Child Health (NICH) hospital of Karachi, Pakistan. Focus group discussions (FGDs) …
Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem
Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem
Community Health Sciences
This paper reviews the very large discrepancies in pregnancy outcomes between high, low and middle-income countries and then presents the medical causes of maternal mortality, stillbirth and neonatal mortality in low-and middle-income countries. Next, we explore the medical interventions that were associated with the very rapid and very large declines in maternal, fetal and neonatal mortality rates in the last eight decades in high-income countries. The medical interventions likely to achieve similar declines in pregnancy-related mortality in low-income countries are considered. Finally, the quality of providers and the data to be collected necessary to achieve these reductions are discussed. It …