{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T03:43:14Z","timestamp":1764906194041,"version":"build-2065373602"},"reference-count":30,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["U01 HD040636","U10 HD076457","U10 HD076461","U10 HD076474","U10 HD078437","U10 HD078438","U10 HD078439","U24HD92094","UG1HD076457","UG1HD076461","UG1HD076474","UG1HD078437","UG1HD078438","UG1HD078439"],"award-info":[{"award-number":["U01 HD040636","U10 HD076457","U10 HD076461","U10 HD076474","U10 HD078437","U10 HD078438","U10 HD078439","U24HD92094","UG1HD076457","UG1HD076461","UG1HD076474","UG1HD078437","UG1HD078438","UG1HD078439"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,7,26]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We examined gestational age (GA) estimates for live and still births, and prematurity rates based on last menstrual period (LMP) compared with ultrasonography (USG) among pregnant women at seven sites in six low-resource countries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cohort study<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting and participants<\/jats:title>\n                  <jats:p>This study included data from the Global Network\u2019s population-based Maternal and Newborn Health Registry which follows pregnant women in six low-income and middle-income countries (Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan and Zambia). Participants in this analysis were 42\u2009803\u2009women, including their 43\u2009230 babies, who registered for the study in their first trimester based on GA estimated either by LMP or USG and had a live or stillbirth with an estimated GA of 20\u201342 weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures<\/jats:title>\n                  <jats:p>GA was estimated in weeks and days based on LMP and\/or USG. Prematurity was defined as GA of 20 weeks+0\u2009days through 36 weeks+6\u2009days, calculated by both USG and LMP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, average GA varied \u22641\u2009week between LMP and USG. Mean GA for live births by LMP was lower than by USG (adjusted mean difference (95%\u2009CI) = \u22120.23 (\u20130.29 to \u20130.17) weeks). Among stillbirths, a higher GA was estimated by LMP than USG (adjusted mean difference (95%\u2009CI)= 0.42 (0.11 to 0.72) weeks). Preterm birth rates for live births were significantly higher when dated by LMP (adjusted rate difference (95%\u2009CI)= 4.20 (3.56 to 4.85)). There was no significant difference in preterm birth rates for stillbirths.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The small differences in GA for LMP versus USG in the Guatemalan and Indian sites suggest that LMP may be a useful alternative to USG for GA dating during the first trimester until availability of USG improves in those areas. Further research is needed to assess LMP for first-trimester GA dating in other regions with limited access to USG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01073475\">NCT01073475<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-067470","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T20:50:28Z","timestamp":1695243028000},"page":"e067470","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Can the date of last menstrual period be trusted in the first trimester? Comparisons of gestational age measures from a prospective cohort study in six low-income to middle-income countries"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct01073475","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2558-7421","authenticated-orcid":false,"given":"Archana","family":"Patel","sequence":"first","affiliation":[{"name":"Lata Medical Research Foundation, Nagpur, Nagpur, Maharashtra, India"},{"name":"Datta Meghe Institute of Medical Sciences, Wardha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9305-8305","authenticated-orcid":false,"given":"Carla M","family":"Bann","sequence":"additional","affiliation":[{"name":"Statistics Division, RTI International, Research Triangle Park, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa R","family":"Thorsten","sequence":"additional","affiliation":[{"name":"Statistics Division, RTI International, Research Triangle Park, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sowmya R","family":"Rao","sequence":"additional","affiliation":[{"name":"School of Public Health, Boston University, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Lokangaka","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoinette","family":"Tshefu Kitoto","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of 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Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherri","family":"Bucher","sequence":"additional","affiliation":[{"name":"Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-8631","authenticated-orcid":false,"given":"Sarah","family":"Saleem","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert L","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"School of Medicine, Columbia University, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elwyn","family":"Chomba","sequence":"additional","affiliation":[{"name":"University of Zambia University Teaching Hospital, Lusaka, Lusaka, 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