{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:35:23Z","timestamp":1789428923767,"version":"build-2803163510"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068633"],"award-info":[{"award-number":["UM1AI068633"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068615"],"award-info":[{"award-number":["UM1AI068615"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI106707"],"award-info":[{"award-number":["UM1AI106707"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>A systematic chart review was performed to estimate the frequency of pregnancy outcomes, pregnancy complications and neonatal outcomes at facilities in Blantyre, Malawi; Johannesburg, South Africa; Kampala, Uganda; and Chitungwiza and Harare, Zimbabwe to provide comparisons with estimates from an ongoing clinical trial evaluating the safety of two biomedical HIV prevention interventions in pregnancy. A multi-site, cross-sectional chart review was conducted at Maternal Obstetric Units and hospitals where women participating in the ongoing clinical trial would be expected to deliver. All individuals delivering at the designated facilities or admitted for postpartum care within seven days of a delivery elsewhere (home, health clinic, etc.) were included in the review. Data were abstracted for pregnancy outcomes, pregnancy complications, maternal and neonatal death, and congenital anomalies. Data from 10,138 records were abstracted across all four sites (Blantyre n = 2,384; Johannesburg n = 1,888; Kampala n = 3,708; Chitungwiza and Harare n = 2,158), which included 10,426 pregnancy outcomes. The prevalence of preterm birth was 13% (range across sites: 10.4\u201320.7) and 4.1% of deliveries resulted in stillbirth (range: 3.1\u20135.5). The most commonly noted pregnancy complication was gestational hypertension, reported among 4.4% of pregnancies. Among pregnancies resulting in a live birth, 15.5% were low birthweight (range: 13.8\u201317.4) and 2.0% resulted in neonatal death (range:1.2\u20133.2). Suspected congenital anomalies were noted in 1.2% of pregnancies. This study provides systematically collected data on background rates of pregnancy outcomes, pregnancy complications and neonatal outcomes that can be used as a reference in support of ongoing HIV prevention studies. In addition, estimates from this study provide important background data for future studies of investigational products evaluated in pregnancy in these urban settings.<\/jats:p>","DOI":"10.1371\/journal.pone.0248423","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T17:23:41Z","timestamp":1617211421000},"page":"e0248423","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Assessing pregnancy and neonatal outcomes in Malawi, South Africa, Uganda, and Zimbabwe: Results from a systematic chart review"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9950-2523","authenticated-orcid":true,"given":"Jennifer E.","family":"Balkus","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moni","family":"Neradilek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Fairlie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonus","family":"Makanani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3085-5259","authenticated-orcid":true,"given":"Nyaradzo","family":"Mgodi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Mhlanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemensia","family":"Nakabiito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8500-2256","authenticated-orcid":true,"given":"Ashley","family":"Mayo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Harrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanna","family":"Piper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Bunge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the MTN-042B Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"pone.0248423.ref001","unstructured":"UNAIDS. Global AIDS Update 2019. https:\/\/wwwunaidsorg\/sites\/default\/files\/media_asset\/2019-global-aids-update_key-messages_enpdf; accessed 20 July 2020."},{"issue":"2","key":"pone.0248423.ref002","doi-asserted-by":"crossref","first-page":"e1001608","DOI":"10.1371\/journal.pmed.1001608","article-title":"Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis","volume":"11","author":"AL Drake","year":"2014","journal-title":"PLoS Med"},{"issue":"22","key":"pone.0248423.ref003","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1056\/NEJMoa1506110","article-title":"Use of a Vaginal Ring Containing Dapivirine for HIV-1 Prevention in Women","volume":"375","author":"JM Baeten","year":"2016","journal-title":"N Engl J Med"},{"issue":"22","key":"pone.0248423.ref004","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1056\/NEJMoa1602046","article-title":"Safety and Efficacy of a Dapivirine Vaginal Ring for HIV Prevention in Women","volume":"375","author":"A Nel","year":"2016","journal-title":"N Engl J Med"},{"key":"pone.0248423.ref005","unstructured":"Network HPT. HPTN 083 Study Demonstrates Superiority of Cabotegravir for the Prevention of HIV. https:\/\/wwwhptnorg\/news-and-events\/press-releases\/hptn-083-study-demonstrates-superiority-cabotegravir-prevention-hiv; accessed 20 July 2020."},{"key":"pone.0248423.ref006","unstructured":"Group. TPW. Ending the evidence gap for pregnant women around HIV & co-infections: A call to action. Chapel Hill, NC: July, 2020. http:\/\/wwwhivpregnancyethicsorg\/; accessed 21 July 2020."},{"key":"pone.0248423.ref007","unstructured":"Network MT. MTN-042: Phase 3b, Randomized, Open Label Safety Trial of Dapivirine Vaginal Ring (VR) and Oral FTC\/TDF Use in Pregnancy https:\/\/wwwmtnstopshivorg\/research\/studies\/mtn-042; accessed 20 July 2020."},{"key":"pone.0248423.ref008","doi-asserted-by":"crossref","unstructured":"Lokken E, Mathur A, Bunge K, Fairlie L, Makanani B, Beigi R, et al. Pooled prevalence of adverse pregnancy and neonatal outcomes in Malawi, South Africa, Uganda, and Zimbabwe\u2014Results from a comprehensive literature review and meta-analysis Under review. 2020.","DOI":"10.3389\/frph.2021.672446"},{"key":"pone.0248423.ref009","unstructured":"WHO. MATERNAL, NEWBORN, CHILD & ADOLESCENT HEALTH Data Portal. https:\/\/wwwwhoint\/data\/maternal-newborn-child-adolescent\/monitor; accessed 20 July 2020."},{"key":"pone.0248423.ref010","unstructured":"UNICEF. Multiple Indicator Cluster Surveys. https:\/\/micsuniceforg\/; accessed 20 July 2020."},{"key":"pone.0248423.ref011","unstructured":"Microbicide Trials Network. MTN-042B: Assessing Baseline Pregnancy Outcomes in Sub-Saharan Africa. https:\/\/mtnstopshivorg\/research\/studies\/mtn-042b; accessed 12 December 2019."},{"key":"pone.0248423.ref012","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"issue":"7","key":"pone.0248423.ref013","doi-asserted-by":"crossref","first-page":"e0199555","DOI":"10.1371\/journal.pone.0199555","article-title":"Pregnancy outcomes among HIV-infected women who conceived on antiretroviral therapy","volume":"13","author":"EM Stringer","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"pone.0248423.ref014","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1016\/S2352-3018(16)30195-3","article-title":"Timing of initiation of antiretroviral therapy and adverse pregnancy outcomes: a systematic review and meta-analysis","volume":"4","author":"OA Uthman","year":"2017","journal-title":"The lancet HIV"},{"issue":"1","key":"pone.0248423.ref015","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/S2214-109X(18)30451-0","article-title":"Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis","volume":"7","author":"S Chawanpaiboon","year":"2019","journal-title":"The Lancet Global health"},{"key":"pone.0248423.ref016","unstructured":"WHO. Global Health Observatory Data Repository: Stillbirth Rate Data by Country (last updated 2017-03-21). https:\/\/appswhoint\/gho\/data\/viewmainGSWCAH06v; accessed 28 July 2020. 2017."},{"issue":"10","key":"pone.0248423.ref017","doi-asserted-by":"crossref","first-page":"e172222","DOI":"10.1001\/jamapediatrics.2017.2222","article-title":"Comparative Safety of Antiretroviral Treatment Regimens in Pregnancy","volume":"171","author":"R Zash","year":"2017","journal-title":"JAMA Pediatrics"},{"key":"pone.0248423.ref018","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.preghy.2019.05.015","article-title":"Combined antiretroviral therapy for HIV and the risk of hypertensive disorders of pregnancy: A systematic review","volume":"17","author":"A Premkumar","year":"2019","journal-title":"Pregnancy Hypertens"},{"issue":"49","key":"pone.0248423.ref019","doi-asserted-by":"crossref","first-page":"5993","DOI":"10.1016\/j.vaccine.2016.07.006","article-title":"Global alignment of immunization safety assessment in pregnancy\u2014The GAIA project","volume":"34","author":"J Bonhoeffer","year":"2016","journal-title":"Vaccine"},{"issue":"1","key":"pone.0248423.ref020","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jmwh.2009.02.014","article-title":"Measurement of blood loss: review of the literature","volume":"55","author":"MN Schorn","year":"2010","journal-title":"J Midwifery Womens Health"},{"issue":"48 Pt A","key":"pone.0248423.ref021","first-page":"6469","article-title":"Safety assessment of immunization in pregnancy","volume":"35","author":"http:\/\/www.gaia-consortium.net GPPEa","year":"2017","journal-title":"Vaccine"},{"issue":"3","key":"pone.0248423.ref022","doi-asserted-by":"crossref","first-page":"176","DOI":"10.2471\/BLT.11.092759","article-title":"Improving public health information: a data quality intervention in KwaZulu-Natal, South Africa","volume":"90","author":"W Mphatswe","year":"2012","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0248423.ref023","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1365-3156.2008.02181.x","article-title":"Accuracy and quality of immunization information systems in forty-one low income countries","volume":"14","author":"X Bosch-Capblanch","year":"2009","journal-title":"Tropical medicine & international health: TM & IH"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0248423","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T01:35:09Z","timestamp":1671759309000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0248423"}},"subtitle":[],"editor":[{"given":"Tai-Heng","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,3,31]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0248423","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,31]]}}}