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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 (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (91st percentile)

Mentioned by

news
2 news outlets
policy
1 policy source
twitter
6 X users
facebook
1 Facebook page

Citations

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103 Dimensions

Readers on

mendeley
316 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.

X Demographics

X Demographics

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

Mendeley readers

The data shown below were compiled from readership statistics for 316 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 308 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 74 23%
Researcher 35 11%
Student > Postgraduate 30 9%
Student > Bachelor 27 9%
Student > Ph. D. Student 21 7%
Other 50 16%
Unknown 79 25%
Readers by discipline Count As %
Medicine and Dentistry 120 38%
Nursing and Health Professions 46 15%
Social Sciences 24 8%
Agricultural and Biological Sciences 6 2%
Arts and Humanities 6 2%
Other 30 9%
Unknown 84 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 23. 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 21 March 2023.
All research outputs
#1,674,167
of 25,964,892 outputs
Outputs from Reproductive Health
#141
of 1,609 outputs
Outputs of similar age
#12,948
of 213,155 outputs
Outputs of similar age from Reproductive Health
#1
of 12 outputs
Altmetric has tracked 25,964,892 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,609 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.0. This one has done particularly well, scoring higher than 91% 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 213,155 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 93% of its contemporaries.
We're also able to compare this research output to 12 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 91% of its contemporaries.