Maternal near-miss among women with a migrant background in Germany.

OBJECTIVE: To examine the association between region of origin and severe illness bringing a mother close to death (near-miss). DESIGN: Retrospective cohort study. SETTING: Maternity units in Lower Saxony, Germany. POPULATION: 441 199 mothers of singleton newborns in 2001-2007. METHODS: Using chi-squared tests, bivariate and multivariable logistic regression we examined the association between maternal region of origin and near-miss outcomes with prospectively collected perinatal data up to seven days postpartum. MAIN OUTCOME MEASURES: Hysterectomy, hemorrhage, eclampsia and sepsis rates. RESULTS: Eclampsia was not associated with region of origin. Compared to women from Germany, women from the Middle East (OR 2.24; 95%CI 1.60-3.12) and Africa/Latin America/other countries (OR 2.17; 95%CI 1.15-4.07) had higher risks of sepsis. Women from Asia (OR 3.37; 95%CI 1.66-6.83) and from Africa/Latin America/other countries had higher risks of hysterectomy (OR 2.65; 95%CI 1.36-5.17). Compared to German women, the risk of hemorrhage was higher among women from Asia (OR 1.55; 95%CI 1.19-2.01) and lower among women from the Middle East (OR 0.66, 95%CI 0.55-0.78). Adjusting for maternal age, parity, occupation, partner status, smoking, obesity, prenatal care, chronic conditions and infertility showed no association between country of origin and risk of sepsis. CONCLUSION: Region of origin was a strong predictor for near-miss among women from the Middle East, Asia and Africa/Latin America/other countries. Confounders mostly did not explain the higher risks for maternal near-miss in these groups of origin. Clinical studies and audits are required to examine the underlying causes for these risks.

A response to Rome: lessons from pre- and post-publication data-sharing in the C. elegans research community.

BACKGROUND: In recent years numerous studies have undertaken to measure the impact of patents, material transfer agreements, data-withholding and commercialization pressures on biomedical researchers. Of particular concern is the theory that such pressures may have negative effects on academic and other upstream researchers. In response to these concerns, commentators in some research communities have called for an increased level of access to, and sharing of, data and research materials. We have been studying how data and materials are shared in the community of researchers who use the nematode Caenorhabditis elegans (C. elegans) as a model organism for biological research. Specifically, we conducted a textual analysis of academic articles referencing C. elegans, reviewed C. elegans repository request lists, scanned patents that reference C. elegans and conducted a broad survey of C. elegans researchers. Of particular importance in our research was the role of the C. elegans Gene Knockout Consortium in the facilitation of sharing in this community. RESULTS: Our research suggests that a culture of sharing exists within the C. elegans research community. Furthermore, our research provides insight into how this sharing operates and the role of the culture that underpins it. CONCLUSIONS: The greater scientific community is likely to benefit from understanding the factors that motivate C. elegans researchers to share. In this sense, our research is a 'response' to calls for a greater amount of sharing in other research communities, such as the mouse community, specifically, the call for increased investment and support of centralized resource sharing infrastructure, grant-based funding of data-sharing, clarity of third party recommendations regarding sharing, third party insistence of post-publication data sharing, a decrease in patenting and restrictive material transfer agreements, and increased attribution and reward.