全球母婴健康网络注册研究:一项基于社区的多国妊娠结局注册研究。

The Global Network Maternal Newborn Health Registry: a multi-country, community-based registry of pregnancy outcomes.

机构信息

Social, Statistical and Environmental Health Sciences, RTI International, 3040 Cornwallis Rd., Durham, NC, 27709, USA.

Instituto de Nutrición de Centroamérica y Panamá, Guatemala City, Guatemala.

出版信息

Reprod Health. 2020 Nov 30;17(Suppl 2):184. doi: 10.1186/s12978-020-01020-8.

Abstract

BACKGROUND

The Global Network for Women's and Children's Health Research (Global Network) conducts clinical trials in resource-limited countries through partnerships among U.S. investigators, international investigators based in in low and middle-income countries (LMICs) and a central data coordinating center. The Global Network's objectives include evaluating low-cost, sustainable interventions to improve women's and children's health in LMICs. Accurate reporting of births, stillbirths, neonatal deaths, maternal mortality, and measures of obstetric and neonatal care is critical to determine strategies for improving pregnancy outcomes. In response to this need, the Global Network developed the Maternal Newborn Health Registry (MNHR), a prospective, population-based registry of pregnant women, fetuses and neonates receiving care in defined catchment areas at the Global Network sites. This publication describes the MNHR, including participating sites, data management and quality and changes over time.

METHODS

Pregnant women who reside in or receive healthcare in select communities are enrolled in the MNHR of the Global Network. For each woman and her offspring, sociodemographic, health care, and the major outcomes through 42-days post-delivery are recorded. Study visits occur at enrollment during pregnancy, at delivery and at 42 days postpartum.

RESULTS

From 2010 through 2018, the Global Network MNHR sites were located in Guatemala, Belagavi and Nagpur, India, Pakistan, Democratic Republic of Congo, Kenya, and Zambia. During this period at these sites, 579,140 pregnant women were consented and enrolled in the MNHR, nearly 99% of all eligible women. Delivery data were collected for 99% of enrolled women and 42-day follow-up data for 99% of those delivered. In this supplement, the trends over time and assessment of differences across geographic regions are analyzed in a series of 18 manuscripts utilizing the MNHR data.

CONCLUSIONS

Improving maternal, fetal and newborn health in countries with poor outcomes requires an understanding of the characteristics of the population, quality of health care and outcomes. Because the worst pregnancy outcomes typically occur in countries with limited health registration systems and vital records, alternative registration systems may prove to be highly valuable in providing data. The MNHR, an international, multicenter, population-based registry, assesses pregnancy outcomes over time in support of efforts to develop improved perinatal healthcare in resource-limited areas. Trial Registration The Maternal Newborn Health Registry is registered at Clinicaltrials.gov (ID# NCT01073475). Registered February 23, 2019. https://clinicaltrials.gov/ct2/show/NCT01073475.

摘要

背景

全球妇女儿童健康研究网络(全球网络)通过美国研究人员、设在中低收入国家(LMIC)的国际研究人员以及一个中央数据协调中心之间的伙伴关系,在资源有限的国家开展临床试验。全球网络的目标包括评估低成本、可持续的干预措施,以改善 LMIC 中妇女和儿童的健康。准确报告出生、死产、新生儿死亡、孕产妇死亡以及产科和新生儿护理措施,对于确定改善妊娠结局的策略至关重要。为了满足这一需求,全球网络开发了孕产妇新生儿健康登记处(MNHR),这是一个前瞻性的、基于人群的登记处,登记了在全球网络地点的特定地理区域内接受护理的孕妇、胎儿和新生儿。本出版物介绍了 MNHR,包括参与的地点、数据管理以及质量和随时间的变化。

方法

居住在特定社区或在这些社区接受医疗保健的孕妇被纳入全球网络的 MNHR。为每位妇女及其后代记录社会人口统计学、医疗保健以及分娩后 42 天内的主要结局。研究访问在怀孕期间、分娩时和产后 42 天进行。

结果

2010 年至 2018 年期间,全球网络 MNHR 地点位于危地马拉、印度贝拉加维(Belagavi)和那格浦尔(Nagpur)、巴基斯坦、刚果民主共和国、肯尼亚和赞比亚。在此期间,这些地点有 579,140 名孕妇同意并纳入 MNHR,几乎占所有符合条件的妇女的 99%。收集了 99%已登记孕妇的分娩数据和 99%分娩妇女的 42 天随访数据。本增刊利用 MNHR 数据分析了 18 篇论文中随时间推移的趋势以及不同地理区域之间的差异评估。

结论

要改善结局较差国家的孕产妇、胎儿和新生儿健康,需要了解人群特征、医疗保健质量和结局。由于最严重的妊娠结局通常发生在卫生登记系统和生命记录有限的国家,因此替代登记系统可能会在提供数据方面证明非常有价值。MNHR 是一个国际性的、多中心的、基于人群的登记处,评估随时间推移的妊娠结局,以支持在资源有限地区开发改进的围产期保健的努力。

试验注册

产妇新生儿健康登记处在 Clinicaltrials.gov 注册(ID#NCT01073475)。于 2019 年 2 月 23 日注册。https://clinicaltrials.gov/ct2/show/NCT01073475。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/704a/7708188/7073e67864f3/12978_2020_1020_Fig1_HTML.jpg

相似文献

引用本文的文献

本文引用的文献

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索