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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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  • Good Attention Score compared to outputs of the same age (68th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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6 tweeters

Citations

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15 Dimensions

Readers on

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44 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 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 44 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 23%
Student > Postgraduate 7 16%
Researcher 5 11%
Student > Ph. D. Student 5 11%
Professor > Associate Professor 4 9%
Other 11 25%
Unknown 2 5%
Readers by discipline Count As %
Medicine and Dentistry 25 57%
Nursing and Health Professions 9 20%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Unspecified 1 2%
Social Sciences 1 2%
Other 1 2%
Unknown 6 14%

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
#2,911,403
of 11,410,328 outputs
Outputs from BMC Pregnancy and Childbirth
#880
of 2,022 outputs
Outputs of similar age
#82,511
of 262,366 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#35
of 68 outputs
Altmetric has tracked 11,410,328 research outputs across all sources so far. This one has received more attention than most of these and is in the 74th percentile.
So far Altmetric has tracked 2,022 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.1. This one has gotten more attention than average, scoring higher than 55% 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 262,366 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 68% of its contemporaries.
We're also able to compare this research output to 68 others from the same source and published within six weeks on either side of this one. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.