PMID- 31749995
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231019
IS  - 2059-7908 (Print)
IS  - 2059-7908 (Electronic)
IS  - 2059-7908 (Linking)
VI  - 4
IP  - 5
DP  - 2019
TI  - Prognostic models for adverse pregnancy outcomes in low-income and middle-income 
      countries: a systematic review.
PG  - e001759
LID - 10.1136/bmjgh-2019-001759 [doi]
LID - e001759
AB  - INTRODUCTION: Ninety-nine per cent of all maternal and neonatal deaths occur in 
      low-income and middle-income countries (LMIC). Prognostic models can provide 
      standardised risk assessment to guide clinical management and can be vital to 
      reduce and prevent maternal and perinatal mortality and morbidity. This review 
      provides a comprehensive summary of prognostic models for adverse maternal and 
      perinatal outcomes developed and/or validated in LMIC. METHODS: A systematic 
      search in four databases (PubMed/Medline, EMBASE, Global Health Library and The 
      Cochrane Library) was conducted from inception (1970) up to 2 May 2018. Risk of 
      bias was assessed with the PROBAST tool and narratively summarised. RESULTS: 1741 
      articles were screened and 21 prognostic models identified. Seventeen models 
      focused on maternal outcomes and four on perinatal outcomes, of which 
      hypertensive disorders of pregnancy (n=9) and perinatal death including 
      stillbirth (n=4) was most reported. Only one model was externally validated. 
      Thirty different predictors were used to develop the models. Risk of bias varied 
      across studies, with the item 'quality of analysis' performing the least. 
      CONCLUSION: Prognostic models can be easy to use, informative and low cost with 
      great potential to improve maternal and neonatal health in LMIC settings. 
      However, the number of prognostic models developed or validated in LMIC settings 
      is low and mirrors the 10/90 gap in which only 10% of resources are dedicated to 
      90% of the global disease burden. External validation of existing models 
      developed in both LMIC and high-income countries instead of developing new models 
      should be encouraged. PROSPERO REGISTRATION NUMBER: CRD42017058044.
CI  - (c) Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Heestermans, Tessa
AU  - Heestermans T
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
FAU - Payne, Beth
AU  - Payne B
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
AD  - Women's Health Research Institute, School of Population and Public Health, The 
      University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Kayode, Gbenga Ayodele
AU  - Kayode GA
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
AD  - International Research Centre of Excellence, Institute of Human Virology, Abuja, 
      Nigeria.
FAU - Amoakoh-Coleman, Mary
AU  - Amoakoh-Coleman M
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
AD  - Noguchi Memorial Research Institute for Medical Research, University of Ghana, 
      Legon, Ghana.
FAU - Schuit, Ewoud
AU  - Schuit E
AD  - Julius Center for Health Sciences and Primary Care, University Medical Center 
      Utrecht, Utrecht University, Utrecht, The Netherlands.
FAU - Rijken, Marcus J
AU  - Rijken MJ
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
AD  - Division of Woman and Baby, Universitair Medisch Centrum Utrecht, Utrecht 
      University, Utrecht, The Netherlands.
FAU - Klipstein-Grobusch, Kerstin
AU  - Klipstein-Grobusch K
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
AD  - Division of Epidemiology & Biostatistics, School of Public Health, Faculty of 
      Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, 
      South Africa.
FAU - Bloemenkamp, Kitty
AU  - Bloemenkamp K
AD  - Division of Woman and Baby, Universitair Medisch Centrum Utrecht, Utrecht 
      University, Utrecht, The Netherlands.
FAU - Grobbee, Diederick E
AU  - Grobbee DE
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
FAU - Browne, Joyce L
AU  - Browne JL
AD  - Julius Global Health, Julius Center for Health Sciences and Primary Care, 
      Universitair Medisch Centrum Utrecht, Utrecht University, Utrecht, The 
      Netherlands.
LA  - eng
PT  - Systematic Review
DEP - 20191030
PL  - England
TA  - BMJ Glob Health
JT  - BMJ global health
JID - 101685275
PMC - PMC6830054
OTO - NOTNLM
OT  - maternal health
OT  - obstetrics
OT  - systematic review
COIS- Competing interests: None declared.
EDAT- 2019/11/22 06:00
MHDA- 2019/11/22 06:01
PMCR- 2019/10/30
CRDT- 2019/11/22 06:00
PHST- 2019/06/17 00:00 [received]
PHST- 2019/09/09 00:00 [revised]
PHST- 2019/10/05 00:00 [accepted]
PHST- 2019/11/22 06:00 [entrez]
PHST- 2019/11/22 06:00 [pubmed]
PHST- 2019/11/22 06:01 [medline]
PHST- 2019/10/30 00:00 [pmc-release]
AID - bmjgh-2019-001759 [pii]
AID - 10.1136/bmjgh-2019-001759 [doi]
PST - epublish
SO  - BMJ Glob Health. 2019 Oct 30;4(5):e001759. doi: 10.1136/bmjgh-2019-001759. 
      eCollection 2019.