The Pregnancy Risk Infant Surveillance and Measurement Alliance (PRiSMA) – Pakistan​​​

Pakistan has disproportionately high maternal and neonatal morbidity and mortality. There is a lack of ​​detailed, population-representative data to provide evidence for risk factors, morbidities and mortality among pregnant women and their newborns. The Pregnancy Risk, Infant Surveillance and Measurement Alliance (PRiSMA) is a multicountry open cohort that aims to collect high-dimensional, standardised data across five South Asian and African countries for estimating risk and developing innovative strategies to optimise pregnancy outcomes for mothers and their newborns. This study presents the baseline maternal and neonatal characteristics of the Pakistan site occurring prior to the launch of a multisite, harmonised protocol.​

Participants: PRiSMA Pakistan study is being conducted at two periurban field sites in Karachi, Pakistan. These sites have primary healthcare clinics where pregnant women and their newborns are followed during the antenatal, intrapartum and postnatal periods up to 1 year after delivery. All encounters are captured electronically through a custom-built Android application. A total of 3731 pregnant women with a mean age of 26.6±5.8 years at the time of pregnancy with neonatal outcomes between January 2021 and August 2022 serve as a baseline for the PRiSMA Pakistan study.


George Washington University team: Emily Smith, Fouzia Farooq, Sasha Baumann
PRiSMA operational team: Zahra Hoodbhoy, Imran Nisar, Fyezah Jehan, Nida Yazdani, Uzma Khan, Amna Khan
PRiSMA data team: Mohammad Kashif, Asad Sheikh, Aasia Jamal, Azqa Mazhar
PRiSMA lab team: Aneeta Hotwani, Khalid Wahab, Ejaz Khan
Vital Pakistan Trust team: Karim Jivani, Farzana Shaheen, Kinza Farooqui

​Dissemination, workshops, training

​​​Dr Z​ahra Hoodbhoy represented AKU’s site at the PRiSMA consortium meeting at George Washington University. They discussed harmonizing important maternal and infant morbidity indicators to be measured across Asia and Africa to help with burden estimation, generating evidence regarding understudied issues like STIs and eventual interventions.​​

The PRISMA team went to Zambia January 23 to 26, 2024 for training in the portable MRI or Hyperfine ​imaging, data acquisition and ​management.   

In April 2024, Principal Investigator Dr Emily Smith of George Washington University came to Karachi for a PRiSMA update. GW visit April 2024.docx

Naz S, Jaffar A, Yazdani N, et al. Cohort profile: the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) – Pakistan BMJ Open 2023;13:e078222. doi: 10.1136/bmjopen-2023-078222​