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Validating the WHO maternal near miss tool: comparing high- and low-resource settings

Overview of attention for article published in BMC Pregnancy and Childbirth, June 2017
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (67th percentile)

Mentioned by

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6 tweeters

Citations

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21 Dimensions

Readers on

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60 Mendeley
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Title
Validating the WHO maternal near miss tool: comparing high- and low-resource settings
Published in
BMC Pregnancy and Childbirth, June 2017
DOI 10.1186/s12884-017-1370-0
Pubmed ID
Authors

Tom Witteveen, Hans Bezstarosti, Ilona de Koning, Ellen Nelissen, Kitty W. Bloemenkamp, Jos van Roosmalen, Thomas van den Akker

Abstract

WHO proposed the WHO Maternal Near Miss (MNM) tool, classifying women according to several (potentially) life-threatening conditions, to monitor and improve quality of obstetric care. The objective of this study is to analyse merged data of one high- and two low-resource settings where this tool was applied and test whether the tool may be suitable for comparing severe maternal outcome (SMO) between these settings. Using three cohort studies that included SMO cases, during two-year time frames in the Netherlands, Tanzania and Malawi we reassessed all SMO cases (as defined by the original studies) with the WHO MNM tool (five disease-, four intervention- and seven organ dysfunction-based criteria). Main outcome measures were prevalence of MNM criteria and case fatality rates (CFR). A total of 3172 women were studied; 2538 (80.0%) from the Netherlands, 248 (7.8%) from Tanzania and 386 (12.2%) from Malawi. Total SMO detection was 2767 (87.2%) for disease-based criteria, 2504 (78.9%) for intervention-based criteria and 1211 (38.2%) for organ dysfunction-based criteria. Including every woman who received ≥1 unit of blood in low-resource settings as life-threatening, as defined by organ dysfunction criteria, led to more equally distributed populations. In one third of all Dutch and Malawian maternal death cases, organ dysfunction criteria could not be identified from medical records. Applying solely organ dysfunction-based criteria may lead to underreporting of SMO. Therefore, a tool based on defining MNM only upon establishing organ failure is of limited use for comparing settings with varying resources. In low-resource settings, lowering the threshold of transfused units of blood leads to a higher detection rate of MNM. We recommend refined disease-based criteria, accompanied by a limited set of intervention- and organ dysfunction-based criteria to set a measure of severity.

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 60 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 60 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 11 18%
Student > Master 10 17%
Researcher 8 13%
Student > Ph. D. Student 5 8%
Other 4 7%
Other 15 25%
Unknown 7 12%
Readers by discipline Count As %
Medicine and Dentistry 35 58%
Nursing and Health Professions 10 17%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Social Sciences 1 2%
Arts and Humanities 1 2%
Other 0 0%
Unknown 11 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. 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 29 June 2017.
All research outputs
#4,284,929
of 15,087,888 outputs
Outputs from BMC Pregnancy and Childbirth
#1,310
of 2,791 outputs
Outputs of similar age
#87,446
of 267,952 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#1
of 1 outputs
Altmetric has tracked 15,087,888 research outputs across all sources so far. This one has received more attention than most of these and is in the 71st percentile.
So far Altmetric has tracked 2,791 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one has gotten more attention than average, scoring higher than 52% 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 267,952 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% 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