TY - JOUR
T1 - The project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe)
T2 - A protocol of a prospective, cohort study of causes of mortality among preterm births and stillbirths
AU - McClure, Elizabeth M.
AU - Saleem, Sarah
AU - Goudar, Shivaprasad S.
AU - Dhaded, Sangappa
AU - Guruprasad, G.
AU - Kumar, Yogesh
AU - Tikmani, Shiyam Sunder
AU - Kadir, Masood
AU - Raza, Jamal
AU - Yasmin, Haleema
AU - Moore, Janet L.
AU - Kim, Jean
AU - Bann, Carla
AU - Parlberg, Lindsay
AU - Aceituno, Anna
AU - Carlo, Waldemar A.
AU - Silver, Robert M.
AU - Lamberti, Laura
AU - Patterson, Janna
AU - Goldenberg, Robert L.
N1 - Publisher Copyright:
© 2018 The Author(s).
PY - 2018/6/22
Y1 - 2018/6/22
N2 - Background: In South Asia, where most stillbirths and neonatal deaths occur, much remains unknown about the causes of these deaths. About one-third of neonatal deaths are attributed to prematurity, yet the specific conditions which cause these deaths are often unclear as is the etiology of stillbirths. In low-resource settings, most women are not routinely tested for infections and autopsy is rare. Methods: This prospective, cohort study will be conducted in hospitals in Davengere, India and Karachi, Pakistan. All women who deliver either a stillbirth or a preterm birth at one of the hospitals will be eligible for enrollment. With consent, the participant and, when applicable, her offspring, will be followed to 28-days post-delivery. A series of research tests will be conducted to determine infection and presence of other conditions which may contribute to the death. In addition, all routine clinical investigations will be documented. For both stillbirths and preterm neonates who die ≤ 28 days, with consent, a standard autopsy as well as minimally invasive tissue sampling will be conducted. Finally, an expert panel will review all available data for stillbirths and neonatal deaths to determine the primary and contributing causes of death using pre-specified guidance. Conclusion: This will be among the first studies to prospectively obtain detailed information on causes of stillbirth and preterm neonatal death in low-resource settings in Asia. Determining the primary causes of death will be important to inform strategies most likely to reduce the high mortality rates in South Asia. Trial registration: Clinicaltrials.gov (NCT03438110) Clinical Trial Registry of India (CTRI/2018/03/012281).
AB - Background: In South Asia, where most stillbirths and neonatal deaths occur, much remains unknown about the causes of these deaths. About one-third of neonatal deaths are attributed to prematurity, yet the specific conditions which cause these deaths are often unclear as is the etiology of stillbirths. In low-resource settings, most women are not routinely tested for infections and autopsy is rare. Methods: This prospective, cohort study will be conducted in hospitals in Davengere, India and Karachi, Pakistan. All women who deliver either a stillbirth or a preterm birth at one of the hospitals will be eligible for enrollment. With consent, the participant and, when applicable, her offspring, will be followed to 28-days post-delivery. A series of research tests will be conducted to determine infection and presence of other conditions which may contribute to the death. In addition, all routine clinical investigations will be documented. For both stillbirths and preterm neonates who die ≤ 28 days, with consent, a standard autopsy as well as minimally invasive tissue sampling will be conducted. Finally, an expert panel will review all available data for stillbirths and neonatal deaths to determine the primary and contributing causes of death using pre-specified guidance. Conclusion: This will be among the first studies to prospectively obtain detailed information on causes of stillbirth and preterm neonatal death in low-resource settings in Asia. Determining the primary causes of death will be important to inform strategies most likely to reduce the high mortality rates in South Asia. Trial registration: Clinicaltrials.gov (NCT03438110) Clinical Trial Registry of India (CTRI/2018/03/012281).
KW - Mortality
KW - Preterm birth
KW - South Asia
KW - Stillbirth
UR - http://www.scopus.com/inward/record.url?scp=85049013425&partnerID=8YFLogxK
U2 - 10.1186/s12978-018-0528-1
DO - 10.1186/s12978-018-0528-1
M3 - Article
C2 - 29945651
AN - SCOPUS:85049013425
SN - 1742-4755
VL - 15
JO - Reproductive Health
JF - Reproductive Health
M1 - 89
ER -