The Maternal and Newborn Health Registry Study of the Global Network for Women's and Children's Health Research

Abstract

Objective To implement a vital statistics registry system to register pregnant women and document birth outcomes in the Global Network for Women’s and Children’s Health Research sites in Asia, Africa, and Latin America. Methods The Global Network sites began a prospective population-based pregnancy registry to identify all pregnant women and record pregnancy outcomes up to 42 days post-delivery in more than 100 defined low-resource geographic areas (clusters). Pregnant women were registered during pregnancy, with 42-day maternal and neonatal follow-up recorded—including care received during the pregnancy and postpartum periods. Recorded outcomes included stillbirth, neonatal mortality, and maternal mortality rates. Results In 2010, 72 848 pregnant women were enrolled and 6-week follow-up was obtained for 97.8%. Across sites, 40.7%, 24.8%, and 34.5% of births occurred in a hospital, health center, and home setting, respectively. The mean neonatal mortality rate was 23 per 1000 live births, ranging from 8.2 to 48.5 per 1000 live births. The mean stillbirth rate ranged from 13.7 to 54.4 per 1000 births. Conclusion The registry is an ongoing study to assess the impact of interventions and trends regarding pregnancy outcomes and measures of care to inform public health.

A prospective study of maternal, fetal and neonatal deaths in low- and middle-income countries

“…The study was done in 106 communities at six sites in five low-income countries (Chimaltenango, Guatemala; Nagpur District and Karnataka District, India; Western Provence, Kenya; Thatta District, Pakistan; and Lusaka, Zambia) and at one site in a middle-income country (Corrientes, Argentina). 9 These seven sites were selected by the Eunice Kennedy Shriver National Institute of Child Health and Human Development in the United States of America (USA), which supports the Global Network for Women's and Children's Health Research, to represent rural or semi-urban geographical areas served by government health services. Each site included between six and 24 distinct communities.…”

“…Details of this procedure have been described elsewhere. 9 Study data were entered onto Microsoft Access computer files (Microsoft, Redmond, USA) at each study site and data were edited before transmission to the central data centre at RTI International in the United States, where additional data edits were performed and the data were analysed using SAS version 9.2 (SAS Institute, Cary, USA). The study findings were reported using descriptive statistics and risk ratios were calculated for maternal, fetal and neonatal outcomes.…”

“…5 Similarly, it has been estimated that, in low-income countries almost half of stillbirths occur during or around the time of delivery and nearly three quarters of neonatal deaths take place within the first few days following birth. [6][7][8][9] Thus, the period around delivery is thought to be the time when the woman and her fetus or infant are at the highest risk of dying.…”

“…11,20 In low-income countries, one half to two thirds of births occur either at home or in community health clinics, often without a skilled health-care worker being present. 9,21,22 In these situations, it may not always be possible to transfer a woman to an emergency obstetric care facility in time to perform a life-saving procedure should the need arise. [23][24][25] Furthermore, as more emphasis is placed on delivery at health-care facilities and as women become more aware of the benefits, there has been an increase in the workload at referral hospitals in low-resource areas, many of which are underequipped and understaffed.…”

Universal combination antiretroviral regimens to prevent mother-to-child transmission of HIV in rural Zambia: a two-round cross-sectional study

“…Moreover, other studies carried out in these communities between 2008 and 2011 may also have contributed to improved health outcomes. [28][29][30] Second, the number of HIV infections and deaths among HIVexposed children was relatively small. However, the use of statistical models to estimate the 24-month HIV-free survival rate in children increased the precision of our estimates.…”