Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan
Purpose Pakistan has disproportionately high maternal and neonatal morbidity and mortality. There is a lack of detailed, population-representative data to provide evidence for risk factors, morbidities and mortality among pregnant women and their newborns. The Pregnancy Risk, Infant Surveillance and...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-12-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e078222.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849723779940352000 |
|---|---|
| author | Fyezah Jehan Uzma Khan Zahra Hoodbhoy Emily Smith Fouzia Farooq Muhammad Imran Nisar Ali Jaffar Sabahat Naz Nida Yazdani Muhammad Kashif Zaid Hussain |
| author_facet | Fyezah Jehan Uzma Khan Zahra Hoodbhoy Emily Smith Fouzia Farooq Muhammad Imran Nisar Ali Jaffar Sabahat Naz Nida Yazdani Muhammad Kashif Zaid Hussain |
| author_sort | Fyezah Jehan |
| collection | DOAJ |
| description | Purpose Pakistan has disproportionately high maternal and neonatal morbidity and mortality. There is a lack of detailed, population-representative data to provide evidence for risk factors, morbidities and mortality among pregnant women and their newborns. The Pregnancy Risk, Infant Surveillance and Measurement Alliance (PRISMA) is a multicountry open cohort that aims to collect high-dimensional, standardised data across five South Asian and African countries for estimating risk and developing innovative strategies to optimise pregnancy outcomes for mothers and their newborns. This study presents the baseline maternal and neonatal characteristics of the Pakistan site occurring prior to the launch of a multisite, harmonised protocol.Participants PRISMA Pakistan study is being conducted at two periurban field sites in Karachi, Pakistan. These sites have primary healthcare clinics where pregnant women and their newborns are followed during the antenatal, intrapartum and postnatal periods up to 1 year after delivery. All encounters are captured electronically through a custom-built Android application. A total of 3731 pregnant women with a mean age of 26.6±5.8 years at the time of pregnancy with neonatal outcomes between January 2021 and August 2022 serve as a baseline for the PRISMA Pakistan study.Findings to date In this cohort, live births accounted for the majority of pregnancy outcomes (92%, n=3478), followed by miscarriages/abortions (5.5%, n=205) and stillbirths (2.6%, n=98). Twenty-two per cent of women (n=786) delivered at home. One out of every four neonates was low birth weight (<2500 g), and one out of every five was preterm (gestational age <37 weeks). The maternal mortality rate was 172/100 000 pregnancies, the neonatal mortality rate was 52/1000 live births and the stillbirth rate was 27/1000 births. The three most common causes of neonatal deaths obtained through verbal autopsy were perinatal asphyxia (39.6%), preterm births (19.8%) and infections (12.6%).Future plans The PRISMA cohort will provide data-driven insights to prioritise and design interventions to improve maternal and neonatal outcomes in low-resource regions.Trial registration number NCT05904145. |
| format | Article |
| id | doaj-art-25d9fa3808ed4bbca8d75f1efc18762f |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-25d9fa3808ed4bbca8d75f1efc18762f2025-08-20T03:10:55ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-078222Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – PakistanFyezah Jehan0Uzma Khan1Zahra Hoodbhoy2Emily Smith3Fouzia Farooq4Muhammad Imran Nisar5Ali Jaffar6Sabahat Naz7Nida Yazdani8Muhammad Kashif9Zaid Hussain10Department of Pediatrics and Child Health, Medical College, Aga Khan University, Karachi, PakistanInteractive Research and Development Global, SingaporeDepartment of Pediatrics and Child Health, Aga Khan University, Karachi, PakistanDepartment of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, Columbia, USADepartment of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, Columbia, USAPediatrics and Child Health, Aga Khan University, Karachi, PakistanNational Institute of Cardiovascular Diseases, Karachi, PakistanDepartment of Community Health Sciences, The Aga Khan University, Karachi, PakistanVITAL Pakistan, Karachi, PakistanDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sindh, PakistanDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sindh, PakistanPurpose Pakistan has disproportionately high maternal and neonatal morbidity and mortality. There is a lack of detailed, population-representative data to provide evidence for risk factors, morbidities and mortality among pregnant women and their newborns. The Pregnancy Risk, Infant Surveillance and Measurement Alliance (PRISMA) is a multicountry open cohort that aims to collect high-dimensional, standardised data across five South Asian and African countries for estimating risk and developing innovative strategies to optimise pregnancy outcomes for mothers and their newborns. This study presents the baseline maternal and neonatal characteristics of the Pakistan site occurring prior to the launch of a multisite, harmonised protocol.Participants PRISMA Pakistan study is being conducted at two periurban field sites in Karachi, Pakistan. These sites have primary healthcare clinics where pregnant women and their newborns are followed during the antenatal, intrapartum and postnatal periods up to 1 year after delivery. All encounters are captured electronically through a custom-built Android application. A total of 3731 pregnant women with a mean age of 26.6±5.8 years at the time of pregnancy with neonatal outcomes between January 2021 and August 2022 serve as a baseline for the PRISMA Pakistan study.Findings to date In this cohort, live births accounted for the majority of pregnancy outcomes (92%, n=3478), followed by miscarriages/abortions (5.5%, n=205) and stillbirths (2.6%, n=98). Twenty-two per cent of women (n=786) delivered at home. One out of every four neonates was low birth weight (<2500 g), and one out of every five was preterm (gestational age <37 weeks). The maternal mortality rate was 172/100 000 pregnancies, the neonatal mortality rate was 52/1000 live births and the stillbirth rate was 27/1000 births. The three most common causes of neonatal deaths obtained through verbal autopsy were perinatal asphyxia (39.6%), preterm births (19.8%) and infections (12.6%).Future plans The PRISMA cohort will provide data-driven insights to prioritise and design interventions to improve maternal and neonatal outcomes in low-resource regions.Trial registration number NCT05904145.https://bmjopen.bmj.com/content/13/12/e078222.full |
| spellingShingle | Fyezah Jehan Uzma Khan Zahra Hoodbhoy Emily Smith Fouzia Farooq Muhammad Imran Nisar Ali Jaffar Sabahat Naz Nida Yazdani Muhammad Kashif Zaid Hussain Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan BMJ Open |
| title | Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan |
| title_full | Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan |
| title_fullStr | Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan |
| title_full_unstemmed | Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan |
| title_short | Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan |
| title_sort | cohort profile the pregnancy risk infant surveillance and measurement alliance prisma pakistan |
| url | https://bmjopen.bmj.com/content/13/12/e078222.full |
| work_keys_str_mv | AT fyezahjehan cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT uzmakhan cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT zahrahoodbhoy cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT emilysmith cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT fouziafarooq cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT muhammadimrannisar cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT alijaffar cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT sabahatnaz cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT nidayazdani cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT muhammadkashif cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan AT zaidhussain cohortprofilethepregnancyriskinfantsurveillanceandmeasurementallianceprismapakistan |