In Bangladesh, Every Preemie—SCALE is working with the Projahnmo Research Group on implementation research titled Development and Validation of Measures and Statistical Models to Improve Estimation of Gestational Age before Birth in Low Income Settings.
Determining gestational age (the number of weeks into pregnancy) is difficult in low-income countries due to the inaccuracy of recalling the date of last menstrual period and lack of access to ultrasonography. Because of the critical need for an affordable, appropriate, and accurate method for determination of gestational age, this study aims to create and test the validity of simple measures and statistical models to assess gestational age before birth. This could rapidly improve the availability and coverage of more accurate gestational age determination to guide clinical care (e.g., antenatal corticosteroids, antibiotics, magnesium sulfate, management of obstetrical complications, kangaroo mother care, and referral need) where resources are limited. The measurements done in this study simply require a measuring tape and weight scale.
The study will develop standardized methods to measure symphysis fundal height and abdominal girth in pregnancy, as well as develop and test procedures to improve the reliability of these measurements among different levels of workers. At the end of the study, we aim to have validated a standardized measurement process and developed a statistical model to predict gestational age which may include symphysis fundal height, abdominal girth, and potential factors which may affect their relationship. We will also assess the feasibility of different methods of implementing the measures and model in the clinical setting where ultrasound dating is not commonly available.
The study is being conducted by the Projahnmo research group in Sylhet Bangladesh in collaboration with Every Preemie—SCALE. Projahnmo was established in 2001 by the Johns Hopkins Bloomberg School of Public Health /International Center for Maternal and Neonatal Health and is a collaboration with Brigham and Women’s Hospital/Harvard Medical School, ICDDR,B, Shimantik, Child Health Research Foundation, and the Ministry of Health & Family Welfare of Bangladesh. Every Preemie—SCALE will contribute financial resources, technical support, and aid programmatic dissemination of the findings.