Accuracy of assessment of pregnancy duration by women seeking early abortions

Ellertson, Charlotte; Elul, Batya; Ambardekar, S.; Wood, Lindy; Carroll, J. J.; Coyaji, Kurus

doi:10.1016/s0140-6736(99)10170-3

Cited by 38 publications

(29 citation statements)

References 12 publications

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“…These findings support limited previous data which have suggested that LMP can be a reliable estimate of gestational age among premature infants in a low-resource setting (24). These data indicate that, among premature births, LMP tends to underestimate gestational age modestly, by one day, with a large standard of error (25,26).…”

Section: Discussionsupporting

confidence: 89%

Determining Gestational Age in a Low-resource Setting: Validity of Last Menstrual Period

Rosenberg

Ahmed

et al. 2009

J Health Popul Nutr

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The validity of three methods (last menstrual period [LPM], Ballard and Dubowitz scores) for assessment of gestational age for premature infants in a low-resource setting was assessed, using antenatal ultrasound as the gold standard. It was hypothesized that LMP and other methods would perform similarly in determining postnatal gestational age. Concordance analysis was applied to data on 355 neonates of <33 weeks gestational age enrolled in a topical skin-therapy trial in a tertiary-care children's hospital in Bangladesh. The concordance coefficient for LMP, Ballard, and Dubowitz was 0.878, 0.914, and 0.886 respectively. LMP and Ballard underestimated gestational age by one day (±11) and 2.9 days (±7.8) respectively while Dubowitz overestimated gestational age by 3.9 days (±7.1) compared to ultrasound finding. LMP in a low-resource setting was a more reliable measure of gestational age than previously thought for estimation of postnatal gestational age of preterm infants. Ballard and Dubowitz scores are slightly more reliable but require more technical skills to perform. Additional prospective trials are warranted to examine LMP against antenatal ultrasound for primary assessment of neonatal gestational age in other low-resource settings.

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Section: Discussionsupporting

confidence: 89%

Determining Gestational Age in a Low-resource Setting: Validity of Last Menstrual Period

Rosenberg

Ahmed

et al. 2009

J Health Popul Nutr

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“…Some of the common criticisms of this method are possible inaccurate recall of LMP, including heaping on certain dates, and reliance of the calculations on a “normal” menstrual cycle of 28 days with ovulation on day 14 [53-55]. However, mounting evidence shows that LMP dates can be utilized to estimate gestational age accurately and reliably [56] with a precision of 86%-90% [57]. In a multi-country trial in developing countries that enrolled 799 women from China, Cuba, and India, 99.9% of women were able to provide an exact date for their LMP, and 92.4% of LMP dates were within 1 week of physician clinical assessments [58].…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of preterm birth in a rural Bangladeshi cohort

et al. 2014

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BackgroundGlobally, about 15 million neonates are born preterm and about 85% of global preterm birth occurs in Asia and Africa regions. We aimed to estimate the incidence and risk factors for preterm birth in a rural Bangladeshi cohort.MethodsBetween June 2007 and September 2009, community health workers prospectively collected data from 32,126 mother-live-born baby pairs on household socio-demographic status, pregnancy history, antenatal care seeking and newborn gestational age determined by recall of date of last menstrual period.ResultsAmong all live births, 22.3% were delivered prior to 37 weeks of gestation (i.e. preterm); of which 12.3% were born at 35–36 weeks of gestation (late preterm), 7.1% were born at 32–34 weeks (moderate preterm), and 2.9% were born at 28–31 weeks of gestation (very preterm). Overall, the majority of preterm births (55.1%) were late preterm. Risk of preterm birth was lower among women with primary or higher level of education (RR: 0.92; 95% CI: 0.88, 0.97), women who sought antenatal care at least once during the index pregnancy (RR: 0.86; 95% CI: 0.83, 0.90), and women who had completed all birth preparedness steps (RR: 0.32; 95% CI: 0.30, 0.34). In contrast, risk of preterm birth was higher among women with a history of child death (RR: 1.05; 95% CI: 1.01, 1.10), who had mid-upper arm circumference (MUAC) ≤250 mm, indicative of under nutrition (for women having MUAC <214 mm the risk was higher; RR: 1.26; 95% CI: 1.17, 1.35), who reported an antenatal complication (RR: 1.32; 95% CI: 1.14, 1.53), and who received iron-folic acid supplementation for 2–6 months during the index pregnancy (RR: 1.33; 95% CI: 1.24, 1.44).ConclusionsIn resource poor settings with high burden of preterm birth, alike Bangladesh, preterm birth risk could be reduced by close monitoring and/or frequent follow-up of women with history of child death and antenatal complications, by encouraging women to seek antenatal care from qualified providers, to adopt birth preparedness planning and to maintain good nutritional status. Additional research is needed to further explore the associations of antenatal iron supplementation and maternal nutritional status on preterm birth.

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“…Its limitations are discussed as being a determinant based on self-reporting and therefore felt to be imprecise. Studies have shown, however, that women who were certain of their LMP were accurate in their assessment of pregnancy duration compared with their ultrasound dating [71].…”

Section: Preamblementioning

confidence: 98%

Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data

Quinn

Muñoz

Gonik

et al. 2016

Vaccine

377

229

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Preterm birth is commonly defined as any birth before 37 weeks completed weeks of gestation. An estimated 15 million infants are born preterm globally, disproportionately affecting low and middle income countries (LMIC). It contributes directly to estimated one million neonatal deaths annually and is a significant contributor to childhood morbidity. However, in many clinical settings, the information available to calculate completed weeks of gestation varies widely. Accurate dating of the last menstrual period (LMP), as well as access to clinical and ultrasonographic evaluation are important components of gestational age assessment antenatally. This case definition assign levels of confidence to categorisation of births as preterm, utilising assessment modalities which may be available across different settings. These are designed to enable systematic safety evaluation of vaccine clinical trials and post-implementation programmes of immunisations in pregnancy.

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Accuracy of assessment of pregnancy duration by women seeking early abortions

Cited by 38 publications

References 12 publications

Determining Gestational Age in a Low-resource Setting: Validity of Last Menstrual Period

Determining Gestational Age in a Low-resource Setting: Validity of Last Menstrual Period

Incidence and risk factors of preterm birth in a rural Bangladeshi cohort

Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data

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