tbuckley/cabot-search huggingface dataset:
Non-alcoholic fatty liver disease and risk of incident acute myocardial infarction and stroke: findings from matched cohort study of 18 million European adults
Authors: Myriam Alexander, A Katrina Loomis, Johan van der Lei, Talita Duarte-Salles, Daniel Prieto-Alhambra, David Ansell, Alessandro Pasqua, Francesco Lapi, Peter Rijnbeek, Mees Mosseveld, Paul Avillach, Peter Egger, Nafeesa N Dhalwani, Stuart Kendrick, Carlos Celis-Morales, Dawn M Waterworth, William Alazawi, Naveed Sattar
Journal: BMJ (2019)

To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH).Matched cohort study.Population based, electronic primary healthcare databases before 31 December 2015 from four European countries: Italy (n=1 542 672), Netherlands (n=2 225 925), Spain (n=5 488 397), and UK (n=12 695 046).120 795 adults with a recorded diagnosis of NAFLD or NASH and no other liver diseases, matched at time of NAFLD diagnosis (index date) by age, sex, practice site, and visit, recorded at six months before or after the date of diagnosis, with up to 100 patients without NAFLD or NASH in the same database.Primary outcome was incident fatal or non-fatal AMI and ischaemic or unspecified stroke. Hazard ratios were estimated using Cox models and pooled across databases by random effect meta-analyses.120 795 patients with recorded NAFLD or NASH diagnoses were identified with mean follow-up 2.1-5.5 years. After adjustment for age and smoking the pooled hazard ratio for AMI was 1.17 (95% confidence interval 1.05 to 1.30; 1035 events in participants with NAFLD or NASH, 67 823 in matched controls). In a group with more complete data on risk factors (86 098 NAFLD and 4 664 988 matched controls), the hazard ratio for AMI after adjustment for systolic blood pressure, type 2 diabetes, total cholesterol level, statin use, and hypertension was 1.01 (0.91 to 1.12; 747 events in participants with NAFLD or NASH, 37 462 in matched controls). After adjustment for age and smoking status the pooled hazard ratio for stroke was 1.18 (1.11 to 1.24; 2187 events in participants with NAFLD or NASH, 134 001 in matched controls). In the group with more complete data on risk factors, the hazard ratio for stroke was 1.04 (0.99 to 1.09; 1666 events in participants with NAFLD, 83 882 in matched controls) after further adjustment for type 2 diabetes, systolic blood pressure, total cholesterol level, statin use, and hypertension.The diagnosis of NAFLD in current routine care of 17.7 million patient appears not to be associated with AMI or stroke risk after adjustment for established cardiovascular risk factors. Cardiovascular risk assessment in adults with a diagnosis of NAFLD is important but should be done in the same way as for the general population.
Cancer Stem Cell Targeting in Multiple Myeloma by GRN163L, a Novel and Potent Telomerase Inhibitor.
Authors: William Matsui, Qiuju Wang, Milada Vala, James P. Barber, Alan Meeker, Robert Tressler, Calvin Harley, Carol A. Huff, B. Douglas Smith, Richard J. Jones
Journal: Blood (2006)
Potent Graft-Versus-Leukemia Effect After Reduced Intensity (RIC) Allogeneic Stem-Cell Transplantation (ASCT) As Post-Remission Therapy for Intermediate-Risk De-Novo Acute Myeloid Leukemia (AML) with FLT3-ITD Genotype or Wild-Type (WT) NPM1 and CEBPA without FLT3-ITD,
Authors: Gaëlle Labouré, Stephanie Dulucq, Stephane Vigouroux, Éric Lippert, Arnaud Pigneux, Reza Tabrizi, Thibaut Leguay, Krimo Bouabdallah, Marie-Sarah Dilhuydy, Anna Schmitt, Gerald Marit, Francois-Xavier Mahon, Noel Milpied
Journal: Blood (2011)
MUC1 Expression Is Essential For Establishment Of Acute Myeloid Leukemia In Vivo
Authors: Dina Stroopinsky, Hasan Rajabi, Jacalyn Rosenblatt, Heidi Mills, Turner Kufe, Katarina Luptakova, Baldev Vasir, Maxwell D Coll, Palmer Kristen, Akriti Kharbanda, Srivastava Neeharika, Robin Joyce, James D. Levine, Jon Arnason, Richard M. Stone, Pier Paolo Pandolfi, Donald Kufe, David Avigan
Journal: Blood (2013)
Composite Single Cell Genetics and Clonal Phylogeny in Acute Lymphoblastic Leukaemia
Authors: Nicola E Potter, Luca Ermini, Elli Papaemmanuil, Gowri Vijayaraghavan, Ian Titley, Giovanni Cazzaniga, Anthony M Ford, Lyndal Kearney, Peter Campbell, Mel Greaves
Journal: Blood (2012)
CALGB 90003: Adoptive Immunotherapy by Allogeneic Stem Cell Transplantation for Metastatic Renal Cell Carcinoma: An Intergroup Phase II Study.
Authors: Brian I. Rini, Susan Halabi, Robert Barrier, Kim A. Margolin, David Avigan, Theodore Logan, Philip L. McCarthy, Eric S. Small, Charles A. Linker
Journal: Blood (2004)
Graft-Versus-Leukemia Effect Is Equivalent in Recipients of Matched Sibling and Matched Unrelated Donor Conventional Hematopoietic Cell Transplant.
Authors: Mukta Arora, Steven Pavletic, Claudio Anasetti, John Barrett, Tao Wang, Joseph H. Antin, Paolo Di Bartolomeo, Brian J. Bolwell, Christopher Bredeson, Mitchell Cairo, Robert P. Gale, Sergio Giralt, Theresa Hahn, Gregory Hale, Joerg Halter, Madan Jagasia, Mark R. Litzow, Franco Locatelli, Phillip L. McCarthy, Cowan Mort, Effie W. Petersdorf, James Russel, Gary Schiller, Harry S. Schouten, Martin Tallman, Leo F. Verdonck, Joseph Wiley, John R. Wingard, Mary M. Horowitz, Olle Ringden
Journal: Blood (2007)
Trisomy 12 CLL Cells Have High Surface Expression Of Integrins Involved In Lymphocyte Trafficking But This Does Not Translate Into Improved LFA-1-Mediated Motility
Authors: Conor J. O'Donovan, Alan G. Ramsay, Fabienne McClanahan, Laura Rassenti, Thomas J. Kipps, John Gribben, John C. Riches
Journal: Blood (2013)
Efficacy and Safety of Ruxolitinib in Regularly Transfused Patients with Thalassemia: Results from Single-Arm, Multicenter, Phase 2a Truth Study
Authors: Yesim Aydinok, Zeynep Karakas, Elena Cassinerio, Noppadol Siritanaratkul, Antonis Kattamis, Aurelio Maggio, Norbert Hollaender, Bruyère Mahuzier, Brian Gadbaw, Ali T. Taher
Journal: Blood (2016)
Development of an Axl/Mer Dual Inhibitor, ONO-9330547: Promising Single Agent Activity in an Acute Myeloid Leukemia (AML) Model
Authors: Tomoko Yasuhiro, Toshio Yoshizawa, Ryu Fujikawa, Kohei Tanaka, Tomoya Koike, Kazuhito Kawabata
Journal: Blood (2014)
Consequences of 4-1BB-4-1BB Ligand Interaction for NK Cell Anti-Tumor Immunity: Opposite Effects of Seemingly Analogue Molecules in Mice and Men.
Authors: Tina Baessler, Jean E Charton, Corina Buechele, Benjamin J Schmiedel, Frank Gruenebach, Matthias Krusch, Alexander Wacker, Lothar Kanz, Helmut R Salih
Journal: Blood (2009)
The Role of C-KIT Mutations in the Leukemogenesis of Core-Binding Factor Acute Myeloid Leukemia: A Comparative Analysis on Paired Diagnosis and Relapse Samples.
Authors: Der-Cherng Liang, Lee-Yung Shih, Chein-Fuang Huang, Ya-Tzu Chang, Huei-Ying Li, Chang-Liang Lai
Journal: Blood (2006)
Final Report of Safety and Efficacy From a Novel Conditioning Regimen, Individualized Once-Daily Intravenous Busulfan with Bortezomib, in Relapsed Multiple Myeloma Patients Undergoing a Second Autologous Hematopoietic Stem Cell Transplantation.
Authors: Edward A. Stadtmauer, Voravit Ratanatharathorn, Rosa F. Yeh, Cesar O. Freytes, Juan J. Toro, Gorgun Akpek, Entezam A. Sahovic, Guido J. Tricot, Paul J. Shaughnessy, Darrell J. White, Tulio E. Rodriguez, Scott R. Solomon, Louie H. Yu, Shiva Patil, Yiping Sun, Elizabeth Armstrong, Angela Smith, Agnes Elekes, Kazunobu Kato, Donna Reece
Journal: Blood (2012)
Decreased Expression of HOXB4 Gene in Aplastic Anemia; Regulatory Interaction with GATA-2,
Authors: Tohru Fujiwara, Hisayuki Yokoyama, Yoko Okitsu, Mayumi Kamata, Shinichi Fujimaki, Takashi Moriguchi, Shinichiro Takahashi, Emery H Bresnick, Hideo Harigae
Journal: Blood (2011)
Defining Therapy Goals for Major Molecular Remission in Chronic Myeloid Leukemia: Results of the Randomized CML-Study IV
Authors: Susanne Saussele, Rüdiger Hehlmann, Christian Dietz, Susanne Schnittger, Alice Charlotte Fabarius, Lida Kalmanti, Benjamin Hanfstein, Ulrike Proetel, Sebastien Rinaldetti, Hermann Einsele, Christiane Falge, Lothar Kanz, Andreas Neubauer, Michael Kneba, Michael Pfreundschuh, Frank Stegelmann, Cornelius F. Waller, Gabriela M. Baerlocher, Dominik Heim, Stefan W. Krause, Wolf-Karsten Hofmann, Joerg Hasford, Markus Pfirrmann, Andreas Hochhaus, Martin C. Müller, Michael Lauseker
Journal: Blood (2014)
Late Hospitalizations in Long-Term Survivors of Hematopoietic Cell Transplantation (HCT): Report From the Bone Marrow Transplant Study (BMTSS).
Authors: Melanie D Sabado, Can-Lan Sun, Liton Francisco, K. Scott Baker, Daniel Weisdorf, Stephen J. Forman, Smita Bhatia
Journal: Blood (2009)
The Human Gut Virome Is Highly Diverse, Stable, and Individual Specific
Authors: Andrey N. Shkoporov, Adam G. Clooney, Thomas D.S. Sutton, Feargal J. Ryan, Karen M. Daly, James A. Nolan, Siobhan A. McDonnell, Ekaterina V. Khokhlova, Lorraine A. Draper, Amanda Forde, Emma Guerin, Vimalkumar Velayudhan, R. Paul Ross, Colin Hill
Journal: Cell Host & Microbe (2019)
Impact of Donor-Recipient Ethnicity On Risk of Acute Graft-Versus-Host Disease, Leukemia Relapse and Survival in Hematopoietic Stem Cell Transplantation From HLA-Compatible Unrelated Donors. A Report From the International Histocompatibility Workshop Group.
Authors: Yasuo Morishima, Takakazu Kawase, Satoko Morishima, Mari Malkki, Stephen R Spellman, Andrea Velardi, Effie W Petersdorf
Journal: Blood (2009)
Effect of Elotuzumab on Circulating Lymphocytes, Chemokines, and Cytokines In Multiple Myeloma Patients
Authors: Lauri Neyer, Han Ding, Doreen Chen, James P Sheridan, Audie Rice, Balaji Balasa, Steve Keller, Yuni Fang, Angie Albano, Ninian Tran, Vivian Zhao, Daniel EH Afar
Journal: Blood (2010)
CD38 Status of CD34+ Myeloblasts, but Not Side Population (SP) Frequency, Predicts Initial Response to Induction Therapy In Patients with Newly Diagnosed Acute Myeloid Leukemia (AML).
Authors: Mikhail Roshal, Sylvia Chien, Megan Othus, Brent Wood, Frederick R. Appelbaum, Elihu H. Estey, Thalia Papayannopoulou, Pamela S. Becker
Journal: Blood (2010)
IL-18 Secreting CAR T Cells Enhance Cell Persistence, Induce Prolonged B Cell Aplasia and Eradicate CD19+ Tumor Cells without Need for Prior Conditioning
Authors: Mauro P. Avanzi, Dayenne G. van Leeuwen, Xinghuo Li, Kenneth Cheung, Hyebin Park, Terence J. Purdon, Renier J. Brentjens
Journal: Blood (2016)
UK is ranked best at resisting tobacco industry’s influence, Japan worst
Authors: Gareth Iacobucci
Journal: BMJ (2019)

The UK has the least tobacco industry influence in policy making while Japan experiences the greatest interference, a global analysis has concluded.

The first Global Tobacco Industry Interference Index,1 released by Stopping Tobacco Organizations and Products (STOP), a global tobacco industry watchdog, tracks governments’ implementation of the World Health Organisation Framework Convention on Tobacco Control, ranking countries overall interference and their performance on specific metrics such as interference in policy development.

In terms of overall tobacco industry interference in policy making, the UK (with a score of 26 out of 100, the lower being better), Uganda (29), and Iran (30) were the three highest ranked countries in terms of protecting health …
Discontinuation of Imatinib in Japanese Patients with Chronic Myeloid Leukemia,
Authors: Naoto Takahashi, Taiichi Kyo, Yasuhiro Maeda, Takashi Sugihara, Kensuke Usuki, Tatsuya Kawaguchi, Noriko Usui, Shinichiro Okamoto, Yokiko Ohe, Shigeki Ohtake, Kunio Kitamura, Masahide Yamamoto, Hirofumi Teshima, Toshiko Motoji, Toshiharu Tamaki, Kenichi Sawada, Kazuma Ohyashiki
Journal: Blood (2011)
Are ET and PV Patients Two Similar Populations As Concern Thrombotic Risk Factors?
Authors: Alessandro Andriani, Roberto Latagliata, Michele Cedrone, Ambra Di Veroli, Cristina Santoro, Francesca Spirito, Carla Ruscio, Sabrina Crescenzi-Leonetti, Raffaele Porrini, Jonny Di Giandomenico, Nicoletta Villivà, Antonio Spadea, Angela Rago, Cinzia De Gregoris, Paolo Cercola, Barbara Anaclerico, Marianna De Muro, Stefano Felici, Massimo Breccia, Enrico Montefusco, Antonino Bagnato, Giuseppe Cimino, Ignazio Majolino, Maria Gabriella Mazzucconi, Giuliana Alimena, Marco Montanaro
Journal: Blood (2015)
Improved Endothelial Function with Combined Chelation Therapy in Thalassaemia Major.
Authors: Mark A. Tanner, Renzo Galanello, Carlo Dessi, Annalisa Agus, Gillian C. Smith, Mark A. Westwood, Ravi Assomull, Sunil V. Nair, J. Malcolm Walker, Dudley J. Pennell
Journal: Blood (2006)
Endocytosis of the Thrombopoietin Receptor Mpl Regulates Both Megakaryocyte and Erythroid Progenitors and Is Critical for Myelofibrosis Development
Authors: Melissa M Lee-Sundlov, Haley E Ramsey, Robert J Dickey, Martha Sola-Visner, Karin M Hoffmeister, Herve Falet
Journal: Blood (2016)
Brentuximab Vedotin As First Line Salvage Therapy in Relapsed/Refractory HL
Authors: Robert W. Chen, Joycelynne Palmer, Tanya Siddiqi, Sandra H. Thomas, Young Kim, Chen T Binhong, Amrita Krishnan, Nitya Nathwani, Ji-Lian Cai, Michelle Mott, Deron Matsuoka, Stephen J Forman
Journal: Blood (2012)
Immune Privileged Features of Multipotent Mesenchymal Stromal Cells Are Lost after Co-Cultivation with Allogeneic Lymphocytes in Vitro
Authors: Nikolay M Kapranov, Yuliya O Davydova, Nataliya Petinati, Maria V Bakshinskayte, Irina V Galtseva, Nina I. Drize, Larisa A. Kuzmina, Elena N. Parovichnikova, Valeriy G Savchenko
Journal: Blood (2016)
Excellent Event Free (EFS) and Overall Survival (OS) For Children With Standard Risk Acute Lymphoblastic Leukemia (SR ALL) Despite The Absence Of a Significant Impact On Outcome With The Addition Of An Intensified Consolidation: Results Of Children’s Oncology Group (COG) AALL0331
Authors: Kelly W. Maloney, Meenakshi Devidas, Leonard A. Mattano, Alison M. Friedmann, Patrick Buckley, Michael J. Borowitz, Andrew J. Carroll, Julie M. Gastier-Foster, Nyla A. Heerema, Nina Kadan -lottick, Mignon L. Loh, Yousif Matloub, David T. Marshall, Linda C. Stork, Elizabeth A. Raetz, Brent L. Wood, Naomi J. Winick, Stephen P. Hunger, William L. Carroll
Journal: Blood (2013)
Successful Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Mild Renal Dysfunction Calculated By Creatinin Clearance
Authors: Shuntaro Ikegawa, Tomoko Inomata, Naoto Ikeda, Hiroyuki Sugiura, Taiga Kuroi, Takeru Asano, Shohei Yoshida, Hisakazu Nishimori, Ken-ichi Matsuoka, Nobuharu Fujii, Eisei Kondo, Yoshinobu Maeda, Mitsune Tanimoto
Journal: Blood (2016)
Extracellular Vesicles Play an Important Role in Intercellular Communication Between Bone Marrow Stroma and Hematopoietic Progenitor Cells in Myeloproliferative Neoplasms
Authors: Teresa L. Ramos, Luis Ignacio Sánchez-Abarca, Beatriz Rosón, Alba Redondo, Concepción Rodríguez, Haidy Rodríguez, Rebeca Ortega, Ana Rico, Silvia Preciado, Olga López Villar, Sandra Muntión, José Ramón González-Porras, Jesus Hernandez, Javier de las Rivas, Ángel Hernández-Hernández, Fermín Sánchez-Guijo, Consuelo Del Cañizo
Journal: Blood (2016)
Abstract 10100: Central Role of MicroRNA-21 in Atrial Fibrillation Associated with Structural Remodeling
Authors: Eduard Guasch, Sophie Cardin, Xiaobin Luo, Patrice Naud, Khai Le Quang, YanFen Shi, Jean C Tardif, Philippe Comtois, Stanley Nattel
Journal: Circulation (2012)

Background: Heart failure (HF) is a major cause of atrial fibrillation (AF), with fibrosis a putative mechanistic contributor. MiR-21 promotes tissue-fibrosis by downregulating fibroblast Sprouty1,...
GITR Ligation with GITR Ligand On Leukemic Cells Suppresses Induction of Leukemia-Associated Antigen Specific T Cells by Increasing Indoleamine 2, 3-Dioxygenase (IDO) Activity Leading to Kynurenine Secretion.
Authors: Yukio Kondo, Luis Espinoza, Takamasa Katagiri, Zhirong Qi, Shinji Nakao
Journal: Blood (2009)
Prognostic Impact of Mutations in a Large Series of Patients with Myelofibrosis
Authors: Paola Guglielmelli, Flavia Biamonte, Arturo Pereira, Johannah Score, Carmela Mannarelli, Giada Rotunno, Maria Chiara Susini, Ambra Spolverini, Alessandro Pancrazzi, Alberto Bosi, Amy Jones, Katerina Zoi, Andreas Reiter, Andrew Duncombe, Daniela Pietra, Elisa Rumi, Francisco Cervantes, Gianni Barosi, Mario Cazzola, Nick C.P. Cross, Alessandro M. Vannucchi
Journal: Blood (2012)
Treatment of Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma (ALL/LL). Results of a Single Center.
Authors: Josep Sarra, Esmeralda de la Banda, Encuentra Maite, Jose Petit, Eva Gonzalez-Barca, Eva Domingo-Domènech, Ana Carla Oliveira, Santiago Mercadal, Victoria Clapes, Alberto Fernandez de Sevilla
Journal: Blood (2009)
High MET Overexpression Does Not Predict the presence of MET exon 14 Splice Mutations in NSCLC: Results From the IFCT PREDICT.amm study
Authors: Simon Baldacci, Martin Figeac, Martine Antoine, Clotilde Descarpentries, Zoulika Kherrouche, Philippe Jamme, Marie-Christine Copin, David Tulasne, Isabelle Nanni, Michèle Beau-Faller, Samia Melaabi, Guénaëlle Levallet, Elisabeth Quoix, Denis Moro-Sibilot, Sylvie Friard, Pascale Missy, Fabrice Barlesi, Jacques Cadranel, Alexis B. Cortot
Journal: Journal of Thoracic Oncology (2019)
Associations Between Single Nucleotide Polymorphisms in Iron-Related Genes and Iron Status in Multiethnic Populations
Authors: Christine E. McLaren, Stela McLachlan, Chad P. Garner, Chris D. Vulpe, Victor R. Gordeuk, John H. Eckfeldt, Paul C. Adams, Ronald T. Acton, Joseph A. Murray, Catherine Leiendecker-Foster, Beverly M. Snively, Lisa F. Barcellos, James D. Cook, Gordon D. McLaren
Journal: Blood (2011)
Five-Year Clinical Outcome and Valve Durability After Transcatheter Aortic Valve Replacement in High-Risk Patients
Authors: Romain Didier, Hélène Eltchaninoff, Patrick Donzeau-Gouge, Karine Chevreul, Jean Fajadet, Pascal Leprince, Alain Leguerrier, Michel Lièvre, Alain Prat, Emmanuel Teiger, Thierry Lefevre, Didier Tchetché, Didier Carrié, Dominique Himbert, Bernard Albat, Alain Cribier, Arnaud Sudre, Didier Blanchard, Gilles Rioufol, Frederic Collet, Remi Houel, Pierre Dos Santos, Nicolas Meneveau, Said Ghostine, Thibaut Manigold, Philippe Guyon, Thomas Cuisset, Herve Le Breton, Stephane Delepine, Xavier Favereau, Geraud Souteyrand, Patrick Ohlmann, Vincent Doisy, Thérèse Lognoné, Antoine Gommeaux, Jean-Philippe Claudel, Francois Bourlon, Bernard Bertrand, Bernard Iung, Martine Gilard
Journal: Circulation (2018)

The FRANCE-2 registry (French Aortic National Corevalve and Edwards) previously reported good early- and medium-term clinical and echocardiographic efficacy for transcatheter aortic valve replacement. We here report 5-year follow-up results from the registry.The registry includes all consecutive patients undergoing transcatheter aortic valve replacement for severe aortic stenosis in France. Follow-up is scheduled at 30 days, 6 months, then annually from 1 to 5 years. Clinical events were defined according to the Valve Academic Research Consortium criteria, and hemodynamic structural valve deterioration (SVD) was defined according to the consensus statement by the European Association of Percutaneous Cardiovascular Interventions.Between January 2010 and January 2012, 4201 patients were enrolled in 34 centers. Five-year vital status was available for 95.5% of patients; 88.1% had clinical evaluation or died. Overall, at 5 years, all-cause mortality was 60.8% (n=2478; 95% CI, 59.3% to 62.3%). The majority of cardiovascular events occurred in the first month after valve implantation, and incidence remained low thereafter, at <2% per year up to 5 years, except for heart failure. The rate of heart failure was 14.3% at 1 year, then decreased over time to <5% per year. In cumulative incidence function, the rates of severe SVD and moderate/severe SVD at 5 years were 2.5% and 13.3%, respectively. Mortality did not differ between patients with or without severe SVD (hazard ratio, 0.71; 95% CI, 0.47-1.07; P=0.1). Finally, in the population of patients with severe SVD, 1 patient (1.7%) experienced a stroke, and 8 patients presented ≥1 heart failure event (13.3%).The 5-year follow-up results of the FRANCE-2 registry represent the largest long-term data set available in a high-risk population. In surviving patients, the low rate of clinical events and the low level of SVD after 1 year support the long-term efficacy of transcatheter aortic valve replacement in both types of transcatheter prosthesis featuring in the registry.
Infectious Complications and Mortality after Autologous Stem Cell Transplantation for Lymphomas: A Comparison Between HIV-Infected and HIV-Negative Patients
Authors: Juan Churruca, Mariana Bastos-Oreiro, Julia Suárez González, Carolina Martinez-Laperche, Pascual Balsalobre, Pilar Miralles, Juan Berenguer, David Serrano, Mi Kwon, Jorge Gayoso, Jose Luis Diez-Martin
Journal: Blood (2016)
How women are treated during facility-based childbirth in four countries: a cross-sectional study with labour observations and community-based surveys
Authors: Meghan A Bohren, Hedieh Mehrtash, Bukola Fawole, Thae Maung Maung, Mamadou Dioulde Balde, Ernest Maya, Soe Soe Thwin, Adeniyi K Aderoba, Joshua P Vogel, Theresa Azonima Irinyenikan, A Olusoji Adeyanju, Nwe Oo Mon, Kwame Adu-Bonsaffoh, Sihem Landoulsi, Chris Guure, Richard Adanu, Boubacar Alpha Diallo, A Metin Gülmezoglu, Anne-Marie Soumah, Alpha Oumar Sall, Özge Tunçalp
Journal: The Lancet (2019)

BackgroundWomen across the world are mistreated during childbirth. We aimed to develop and implement evidence-informed, validated tools to measure mistreatment during childbirth, and report results from a cross-sectional study in four low-income and middle-income countries.MethodsWe prospectively recruited women aged at least 15 years in twelve health facilities (three per country) in Ghana, Guinea, Myanmar, and Nigeria between Sept 19, 2016, and Jan 18, 2018. Continuous observations of labour and childbirth were done from admission up to 2 h post partum. Surveys were administered by interviewers in the community to women up to 8 weeks post partum. Labour observations were not done in Myanmar. Data were collected on sociodemographics, obstetric history, and experiences of mistreatment.Findings2016 labour observations and 2672 surveys were done. 838 (41·6%) of 2016 observed women and 945 (35·4%) of 2672 surveyed women experienced physical or verbal abuse, or stigma or discrimination. Physical and verbal abuse peaked 30 min before birth until 15 min after birth (observation). Many women did not consent for episiotomy (observation: 190 [75·1%] of 253; survey: 295 [56·1%] of 526) or caesarean section (observation: 35 [13·4%] of 261; survey: 52 [10·8%] of 483), despite receiving these procedures. 133 (5·0%) of 2672 women or their babies were detained in the facility because they were unable to pay the bill (survey). Younger age (15–19 years) and lack of education were the primary determinants of mistreatment (survey). For example, younger women with no education (odds ratio [OR] 3·6, 95% CI 1·6–8·0) and younger women with some education (OR 1·6, 1·1–2·3) were more likely to experience verbal abuse, compared with older women (≥30 years), adjusting for marital status and parity.InterpretationMore than a third of women experienced mistreatment and were particularly vulnerable around the time of birth. Women who were younger and less educated were most at risk, suggesting inequalities in how women are treated during childbirth. Understanding drivers and structural dimensions of mistreatment, including gender and social inequalities, is essential to ensure that interventions adequately account for the broader context.FundingUnited States Agency for International Development and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO.