Basic information such as birth weight, birth length and head circumference, gestational age at birth and mode of delivery are documented by obstetricians or study nurses on a study-specific newborn documentation sheet.
Delivery conditions such as the performance of a caesarian section or an emergent delivery were documented.
We also excluded 3184 (0.3%) records with missing values for time of birth, 334 (0.03%) records with unknown mode of delivery, 717 (0.1%) records where the deliveries were documented to have taken place in hospitals with fewer than 10 deliveries a year, and five records with inconsistent classification of perinatal death.
In preterm deliveries the underlying cause was documented, cases due to maternal and fetal indications were excluded.
All deliveries are hospital based and attended by midwives, and the information was documented by the attending staff.
Geographic variation in cesarean delivery has been documented [ 8- 11], and variation in procedure rates may indicate underutilization or overutilization [ 12].
The use of traditional herbs in pregnancy and delivery has been documented in other African countries and could be toxic to both the mother and the foetus [ 35].
However, the ensuing embryos were typically diagnosed as abnormal and not recommended for transfer (Geraedts et al., 2011) since they were thought to carry other chromosomal errors and their reproductive competence was in question as no deliveries had been documented (Kuliev and Verlinsky, 2004; Fragouli et al., 2006, 2011).
The catastrophic levels and nature of maternity expenditure, especially about delivery expenditure have been documented in previous studies in India [6, 9, 10, 27, 34, 36], but their analyses suffer from data related limitations, especially in terms of completeness of details on maternity expenditure and also in terms of identifying the supply-side factors determining it.
Premature delivery (<37/40) has been documented in the majority of genetically confirmed PNPO-deficient cases reported in the literature with many patients also having low Apgar scores at delivery (often requiring intubation).
