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Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO Antenatal Care Trial

Overview of attention for article published in Reproductive Health, April 2013
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)

Mentioned by

news
2 news outlets
policy
1 policy source
twitter
6 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
86 Dimensions

Readers on

mendeley
267 Mendeley
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Title
Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO Antenatal Care Trial
Published in
Reproductive Health, April 2013
DOI 10.1186/1742-4755-10-19
Pubmed ID
Authors

Joshua P Vogel, Ndema Abu Habib, João Paulo Souza, A Metin Gülmezoglu, Therese Dowswell, Guillermo Carroli, Hassan S Baaqeel, Pisake Lumbiganon, Gilda Piaggio, Olufemi T Oladapo

Abstract

BACKGROUND: In 2001, the WHO Antenatal Care Trial (WHOACT) concluded that an antenatal care package of evidence-based screening, therapeutic interventions and education across four antenatal visits for low-risk women was not inferior to standard antenatal care and may reduce cost. However, an updated Cochrane review in 2010 identified an increased risk of perinatal mortality of borderline statistical significance in three cluster-randomized trials (including the WHOACT) in developing countries. We conducted a secondary analysis of the WHOACT data to determine the relationship between the reduced visits, goal-oriented antenatal care package and perinatal mortality. METHODS: Exploratory analyses were conducted to assess the effect of baseline risk and timing of perinatal death. Women were stratified by baseline risk to assess differences between intervention and control groups. We used linear modeling and Poisson regression to determine the relative risk of fetal death, neonatal death and perinatal mortality by gestational age. RESULTS: 12,568 women attended the 27 intervention clinics and 11,958 women attended the 26 control clinics. 6,160 women were high risk and 18,365 women were low risk. There were 161 fetal deaths (1.4%) in the intervention group compared to 119 fetal deaths in the control group (1.1%) with an increased overall adjusted relative risk of fetal death (Adjusted RR 1.27; 95% CI 1.03, 1.58). This was attributable to an increased relative risk of fetal death between 32 and 36 weeks of gestation (Adjusted RR 2.24; 95% CI 1.42, 3.53) which was statistically significant for high and low risk groups. CONCLUSION: It is plausible the increased risk of fetal death between 32 and 36 weeks gestation could be due to reduced number of visits, however heterogeneity in study populations or differences in quality of care and timing of visits could also be playing a role. Monitoring maternal, fetal and neonatal outcomes when implementing antenatal care protocols is essential. Implementing reduced visit antenatal care packages demands careful monitoring of maternal and perinatal outcomes, especially fetal death.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 267 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 <1%
Tanzania, United Republic of 1 <1%
Uganda 1 <1%
Malawi 1 <1%
Indonesia 1 <1%
India 1 <1%
Peru 1 <1%
Unknown 259 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 68 25%
Researcher 33 12%
Student > Postgraduate 30 11%
Student > Bachelor 25 9%
Student > Ph. D. Student 21 8%
Other 42 16%
Unknown 48 18%
Readers by discipline Count As %
Medicine and Dentistry 114 43%
Nursing and Health Professions 41 15%
Social Sciences 23 9%
Agricultural and Biological Sciences 6 2%
Business, Management and Accounting 5 2%
Other 24 9%
Unknown 54 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 24. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 November 2021.
All research outputs
#1,314,770
of 22,558,544 outputs
Outputs from Reproductive Health
#105
of 1,397 outputs
Outputs of similar age
#10,014
of 177,083 outputs
Outputs of similar age from Reproductive Health
#1
of 1 outputs
Altmetric has tracked 22,558,544 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,397 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.8. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 177,083 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them