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Low birth weight: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data

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      Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.

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      Because of the pressure for timely, informed decisions in public health and clinical practice and the explosion of information in the scientific literature, research results must be synthesized. Meta-analyses are increasingly used to address this problem, and they often evaluate observational studies. A workshop was held in Atlanta, Ga, in April 1997, to examine the reporting of meta-analyses of observational studies and to make recommendations to aid authors, reviewers, editors, and readers. Twenty-seven participants were selected by a steering committee, based on expertise in clinical practice, trials, statistics, epidemiology, social sciences, and biomedical editing. Deliberations of the workshop were open to other interested scientists. Funding for this activity was provided by the Centers for Disease Control and Prevention. We conducted a systematic review of the published literature on the conduct and reporting of meta-analyses in observational studies using MEDLINE, Educational Research Information Center (ERIC), PsycLIT, and the Current Index to Statistics. We also examined reference lists of the 32 studies retrieved and contacted experts in the field. Participants were assigned to small-group discussions on the subjects of bias, searching and abstracting, heterogeneity, study categorization, and statistical methods. From the material presented at the workshop, the authors developed a checklist summarizing recommendations for reporting meta-analyses of observational studies. The checklist and supporting evidence were circulated to all conference attendees and additional experts. All suggestions for revisions were addressed. The proposed checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology, including background, search strategy, methods, results, discussion, and conclusion. Use of the checklist should improve the usefulness of meta-analyses for authors, reviewers, editors, readers, and decision makers. An evaluation plan is suggested and research areas are explored.
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        Epidemiology and causes of preterm birth.

        This paper is the first in a three-part series on preterm birth, which is the leading cause of perinatal morbidity and mortality in developed countries. Infants are born preterm at less than 37 weeks' gestational age after: (1) spontaneous labour with intact membranes, (2) preterm premature rupture of the membranes (PPROM), and (3) labour induction or caesarean delivery for maternal or fetal indications. The frequency of preterm births is about 12-13% in the USA and 5-9% in many other developed countries; however, the rate of preterm birth has increased in many locations, predominantly because of increasing indicated preterm births and preterm delivery of artificially conceived multiple pregnancies. Common reasons for indicated preterm births include pre-eclampsia or eclampsia, and intrauterine growth restriction. Births that follow spontaneous preterm labour and PPROM-together called spontaneous preterm births-are regarded as a syndrome resulting from multiple causes, including infection or inflammation, vascular disease, and uterine overdistension. Risk factors for spontaneous preterm births include a previous preterm birth, black race, periodontal disease, and low maternal body-mass index. A short cervical length and a raised cervical-vaginal fetal fibronectin concentration are the strongest predictors of spontaneous preterm birth.
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          4 million neonatal deaths: when? Where? Why?

          The proportion of child deaths that occurs in the neonatal period (38% in 2000) is increasing, and the Millennium Development Goal for child survival cannot be met without substantial reductions in neonatal mortality. Every year an estimated 4 million babies die in the first 4 weeks of life (the neonatal period). A similar number are stillborn, and 0.5 million mothers die from pregnancy-related causes. Three-quarters of neonatal deaths happen in the first week--the highest risk of death is on the first day of life. Almost all (99%) neonatal deaths arise in low-income and middle-income countries, yet most epidemiological and other research focuses on the 1% of deaths in rich countries. The highest numbers of neonatal deaths are in south-central Asian countries and the highest rates are generally in sub-Saharan Africa. The countries in these regions (with some exceptions) have made little progress in reducing such deaths in the past 10-15 years. Globally, the main direct causes of neonatal death are estimated to be preterm birth (28%), severe infections (26%), and asphyxia (23%). Neonatal tetanus accounts for a smaller proportion of deaths (7%), but is easily preventable. Low birthweight is an important indirect cause of death. Maternal complications in labour carry a high risk of neonatal death, and poverty is strongly associated with an increased risk. Preventing deaths in newborn babies has not been a focus of child survival or safe motherhood programmes. While we neglect these challenges, 450 newborn children die every hour, mainly from preventable causes, which is unconscionable in the 21st century.

            Author and article information

            [a ]Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa
            [b ]Department of Science and Technology National Research Foundation, Vaccine Preventable Diseases, South Africa
            [c ]Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
            [d ]Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Research Institute, Seattle, WA, USA
            [e ]Sanofi Pasteur Inc., Swiftwater, PA, USA
            [f ]ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic – University of Barcelona, Barcelona, Spain
            [g ]Madras Medical College, India
            [h ]Department of Community Medicine, GR Medical College and Associated Hospitals, Gwalior, MP, India
            [i ]Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
            [j ]University of Maryland School of Medicine, Center for Vaccine Development, MD, USA
            [k ]Global Healthcare Consulting, India
            [l ]Baylor College of Medicine, Departments of Pediatrics, Molecular Virology and Microbiology, Houston, TX, USA
            [m ]Erasmus University Medical Center, Rotterdam, The Netherlands
            Author notes
            [* ]Corresponding author at: Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.Medical Research Council: Respiratory and Meningeal Pathogens Research UnitJohannesburgSouth Africa contact@

            Present address: University of Washington, Seattle, USA.


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            Elsevier Science
            04 December 2017
            04 December 2017
            : 35
            : 48Part A
            : 6492-6500
            29150054 5710991 S0264-410X(17)30114-7 10.1016/j.vaccine.2017.01.049
            © 2017 Published by Elsevier Ltd.

            This is an open access article under the CC BY license (



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