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Short VL, Hoffman M, Metgud M, Kavi A, Goudar SS, Okitawutshu J, Tshefu A, Bose CL, Mwenechanya M, Chomba E, Carlo WA, Figueroa L, Garces A, Krebs NF, Jessani S, Saleem S, Goldenberg RL, Das PK, Patel A, Hibberd PL, Achieng E, Nyongesa P, Esamai F, Bucher S, Nowak KJ, Goco N, Nolen TL, McClure EM, Koso-Thomas M, Miodovnik M, Derman RJ. Safety of daily low-dose aspirin use during pregnancy in low-income and middle-income countries. AJOG GLOBAL REPORTS 2021; 1. [PMID: 34085052 PMCID: PMC8171270 DOI: 10.1016/j.xagr.2021.100003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The daily use of low-dose aspirin may be a safe, widely available, and inexpensive intervention for reducing the risk of preterm birth. Data on the potential side effects of low-dose aspirin use during pregnancy in low- and middle-income countries are needed. OBJECTIVE This study aimed to assess differences in unexpected emergency medical visits and potential maternal side effects from a randomized, double-blind, multicountry, placebo-controlled trial of low-dose aspirin use (81 mg daily, from 6 to 36 weeks’ gestation). STUDY DESIGN This study was a secondary analysis of data from the Aspirin Supplementation for Pregnancy Indicated Risk Reduction In Nulliparas trial, a trial of the Global Network for Women's and Children's Health conducted in India (2 sites), Pakistan, Guatemala, Democratic Republic of the Congo, Kenya, and Zambia. The outcomes for this analysis were unexpected emergency medical visits and the occurrence of the following potential side effects—overall and separately—nausea, vomiting, rash or hives, diarrhea, gastritis, vaginal bleeding, allergic reaction, and any other potential side effects. Analyses were performed overall and by geographic region. RESULTS Between the aspirin (n=5943) and placebo (n=5936) study groups, there was no statistically significant difference in the risk of unexpected emergency medical visits or the risk of any potential side effect (overall). Of the 8 potential side effects assessed, only 1 (rash or hives) presented a different risk by treatment group (4.2% in the aspirin group vs 3.5% in the placebo group; relative risk, 1.20; 95% confidence interval, 1.01–1.43; P=.042). CONCLUSION The daily use of low-dose aspirin seems to be a safe intervention for reducing the risk of preterm birth and well tolerated by nulliparous pregnant women between 6 and 36 weeks’ gestation in low- and middle-income countries.
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Affiliation(s)
- Vanessa L Short
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Matthew Hoffman
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Mrityunjay Metgud
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Avinash Kavi
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Shivaprasad S Goudar
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Jean Okitawutshu
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Antoinette Tshefu
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Carl L Bose
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Musaku Mwenechanya
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Elwyn Chomba
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Waldemar A Carlo
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Lester Figueroa
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Ana Garces
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Nancy F Krebs
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Saleem Jessani
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Sarah Saleem
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Robert L Goldenberg
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Prabir Kumar Das
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Archana Patel
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Patricia L Hibberd
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Emmah Achieng
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Paul Nyongesa
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Fabian Esamai
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Sherri Bucher
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Kayla J Nowak
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Norman Goco
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Tracy L Nolen
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Elizabeth M McClure
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Marion Koso-Thomas
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Menachem Miodovnik
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
| | - Richard J Derman
- Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik)
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