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The global network antenatal corticosteroids trial: impact on stillbirth

Overview of attention for article published in Reproductive Health, June 2016
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Title
The global network antenatal corticosteroids trial: impact on stillbirth
Published in
Reproductive Health, June 2016
DOI 10.1186/s12978-016-0174-4
Pubmed ID
Authors

Robert L. Goldenberg, Vanessa R. Thorsten, Fernando Althabe, Sarah Saleem, Ana Garces, Waldemar A. Carlo, Omrana Pasha, Elwyn Chomba, Shivaprasad Goudar, Fabian Esamai, Nancy F. Krebs, Richard J. Derman, Edward A. Liechty, Archana Patel, Patricia L. Hibberd, Pierre M. Buekens, Marion Koso-Thomas, Menachem Miodovnik, Alan H. Jobe, Dennis D. Wallace, José M. Belizán, Elizabeth M. McClure

Abstract

Antenatal corticosteroids are commonly used to reduce neonatal mortality, but most research to date has been in high-resource settings and few studies have evaluated its impact on stillbirth. In the Antenatal Corticosteroids Trial (ACT), a multi-country trial to assess impact of a multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth, we found an overall increase in 28-day neonatal mortality and stillbirth associated with the intervention. The ACT was a cluster-randomized trial conducted in 102 clusters across 7 research sites in 6 countries (India [2 sites], Pakistan, Zambia, Kenya, Guatemala and Argentina), comparing an intervention to train birth attendants at all levels of the health system to identify women at risk of preterm birth, administer corticosteroids and refer women at risk. Because of inadequate gestational age dating, the <5(th) percentile birth weight was used as a proxy for preterm birth. A pre-specified secondary outcome of the trial was stillbirth. After adjusting for the pre-trial imbalance in stillbirth rates, the ACT intervention was associated with a non-significant increased risk of stillbirth (aRR 1.08, 95 % CI, 0.99-1.17, p-0.073). Additionally, the stillbirth rate was higher in the term births (1.20 95 % CI 1.06-1.37, 0.004) and among those with signs of maceration (RR 1.18 (1.04-1.35), p = 0.013) in the intervention vs. control clusters. Differences in obstetric care favored the control clusters and maternal infection was likely more common in the intervention clusters. In this pragmatic trial, limited data were available to identify the causes of the increase in stillbirths in the intervention clusters. A higher rate of stillbirth in the intervention clusters prior to the trial, differences in obstetric care and an increase in maternal infection are potential explanations for the observed increase in stillbirths in the intervention clusters during the trial. clinicaltrials.gov (NCT01084096).

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter 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 82 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 82 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 22%
Student > Postgraduate 8 10%
Student > Ph. D. Student 6 7%
Researcher 5 6%
Student > Bachelor 4 5%
Other 13 16%
Unknown 28 34%
Readers by discipline Count As %
Medicine and Dentistry 29 35%
Social Sciences 8 10%
Psychology 5 6%
Pharmacology, Toxicology and Pharmaceutical Science 2 2%
Nursing and Health Professions 2 2%
Other 7 9%
Unknown 29 35%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 19 May 2017.
All research outputs
#9,212,727
of 10,490,471 outputs
Outputs from Reproductive Health
#619
of 652 outputs
Outputs of similar age
#227,857
of 277,025 outputs
Outputs of similar age from Reproductive Health
#39
of 39 outputs
Altmetric has tracked 10,490,471 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 652 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.4. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 39 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.