{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:08:35Z","timestamp":1793171315296,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The PURPOSe study was a prospective, observational study conducted in India and Pakistan to determine the cause of death for stillbirths and preterm neonatal deaths, using clinical data together with minimally invasive tissue sampling (MITS) and the histologic and polymerase chain reaction (PCR) evaluation of fetal\/neonatal tissues and the placenta. After evaluating all available data, an independent panel chose a maternal, a placental and a fetal\/neonatal cause of death. Here, we summarise the major results. Among the most important findings were that most stillbirths were caused by fetal asphyxia, often preceded by placental malperfusion, and clinically associated with pre\u2010eclampsia, placental abruption and a small\u2010for\u2010gestational\u2010age fetus. The preterm neonatal deaths were primarily caused by birth asphyxia, followed by various infections. An important finding was that many of the preterm neonatal deaths were caused by a nosocomial infection acquired after neonatal intensive care (NICU) admission; the most common organisms were <jats:italic>Acinetobacter baumannii<\/jats:italic>, followed by <jats:italic>Klebsiella pneumoniae<\/jats:italic>, <jats:italic>Escherichia coli\/Shigella<\/jats:italic> and <jats:italic>Haemophilus influenzae<\/jats:italic>. Group\u2009B streptococcus was less commonly present in the placentas or internal organs of the neonatal deaths.<\/jats:p>","DOI":"10.1111\/1471-0528.17635","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T17:41:17Z","timestamp":1692639677000},"page":"26-35","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The PURPOSe cause of death study in stillbirths and neonatal deaths in India and Pakistan: A review"],"prefix":"10.1111","volume":"130","author":[{"given":"Robert L.","family":"Goldenberg","sequence":"first","affiliation":[{"name":"Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Saleem","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivaprasad S.","family":"Goudar","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research's JN Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Moore","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gowdar","family":"Guruprasad","sequence":"additional","affiliation":[{"name":"Bapuji Educational Association's JJM Medical College  Davangere Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vardendra","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Bapuji Educational Association's JJM Medical College  Davangere Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangappa M.","family":"Dhaded","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research's JN Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyam Sunder","family":"Tikmani","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidrah","family":"Nausheen","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shazia","family":"Masheer","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mangala G.","family":"Kallapur","sequence":"additional","affiliation":[{"name":"Bapuji Educational Association's JJM Medical College  Davangere Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najia K.","family":"Ghanchi","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheetal U.","family":"Harakuni","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research's JN Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Hwang","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Yogeshkumar","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research's JN Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8871-5072","authenticated-orcid":false,"given":"Manjunath S.","family":"Somannavar","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research's JN Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haleema","family":"Yasmin","sequence":"additional","affiliation":[{"name":"Jinnah Postgraduate Medical Centre  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Kim","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Bann","sequence":"additional","affiliation":[{"name":"KLE Academy of Higher Education and Research's JN Medical College  Belagavi Karnataka India"},{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Silver","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-5444","authenticated-orcid":false,"given":"Elizabeth M.","family":"McClure","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PURPOSe Study 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