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

2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Elizabeth M. McClure ◽  
Ana L. Garces ◽  
Patricia L. Hibberd ◽  
Janet L. Moore ◽  
Shivaprasad S. Goudar ◽  
...  
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Newborn Health ◽  
Population Based ◽  
Global Network ◽  
Resource Limited ◽  
Health Registry ◽  
Population Based Registry ◽  
Over Time

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

scholarly journals U-Shaped Association between Maternal Hemoglobin and Low Birth Weight in Rural Bangladesh

2021 ◽  
Author(s):  
Rebecca Carpenter ◽  
Masum Billah ◽  
Genevieve Lyons ◽  
Md Shahjahan Siraj ◽  
Qazi Rahman ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Newborn Health ◽  
Global Network ◽  
World Health ◽  
Placental Disease ◽  
The Mean ◽  
Health Registry ◽  
Disease Understanding

Low birth weight (LBW) is associated with a higher risk of neonatal mortality and the development of adult-onset chronic disease. Understanding the ongoing contribution of maternal hemoglobin (Hgb) levels to the incidence of LBW in South Asia is crucial to achieve the World Health Assembly global nutrition target of a 30% reduction in LBW by 2025. We enrolled pregnant women from the rural Tangail District of Bangladesh in a Maternal Newborn Health Registry established under The Global Network for Women’s and Children’s Health Research. We measured the Hgb of pregnant women at enrollment and birth weights of all infants born after 20 weeks gestation. Using logistic regression to adjust for multiple potential confounders, we estimated the association between maternal Hgb and the risk of LBW. We obtained Hgb measurements and birth weights from 1,665 mother–child dyads between July 2019 and April 2020. Using trimester-specific cutoffs for anemia, 48.3% of the women were anemic and the mean (±SD) Hgb level was 10.6 (±1.24) g/dL. We identified a U-shaped relationship where the highest risk of LBW was seen at very low (< 7.0 g/dL, OR = 2.00, 95% CI = 0.43–7.01, P = 0.31) and high (> 13.0 g/dL, OR = 2.17, 95% CI = 1.01–4.38, P = 0.036) Hgb levels. The mechanisms underlying this U-shaped association may include decreased plasma expansion during pregnancy and/or iron dysregulation resulting in placental disease. Further research is needed to explain the observed U-shaped relationship, to guide iron supplementation in pregnancy and to minimize the risk of LBW outcomes.

scholarly journals The Global Network Maternal Newborn Health Registry: a multi-national, community-based registry of pregnancy outcomes

2015 ◽  
Vol 12 (S2) ◽  
Author(s):  
Carl L Bose ◽  
Melissa Bauserman ◽  
Robert L Goldenberg ◽  
Shivaprasad S Goudar ◽  
Elizabeth M McClure ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Newborn Health ◽  
Global Network ◽  
Community Based ◽  
National Community ◽  
Health Registry

Factors Associated with Distribution of Pre-Eclampsia and Eclampsia Among Rural and Urban Women in Child Bearing Age – A Case of Mbala General Hospital, Northern Province, Zambia

2021 ◽  
Vol 9 (3) ◽  
pp. 81-91
Author(s):  
Daniel Sinkala
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Urban Areas ◽  
Quantitative Methods ◽  
Economic Status ◽  
Demographic Factors ◽  
Socio Economic Status ◽  
Resource Limited ◽  
Rural And Urban ◽  
Socio Demographic Factors

Preeclampsia and eclampsia cases continue to rise in northern Zambia as people search for babies and continuity of clans’ survival. Due to the competitive nature of cultural demands/ myths on pregnancy and maternal socio-demographic factors (low-age, low socio-economic status, and poor health-seeking behaviour), women in rural prefer unprofessional primary health care services that are presumably affordable to them thereby, delaying in seeking for professional healthcare services. High levels of poverty in resource-limited areas have put many female adolescents at risk of falling pregnant. Thus, this study probed on the interaction between these maternal socio-demographic factors and disease distribution in both rural and urban areas with respect to various pregnancy outcomes. The study used retrospective quantitative methods in eliciting information from data sources (women, registers) in Mbala, Mpulungu, Senga, and Mungwi districts covering 3-year period (2017-2019). In all, 202 female respondents from Northern Zambia were interviewed through self-administered questionnaires. Thereafter, data were analysed using a statistical package for the social sciences (SPSS v16). Findings indicate severe; socio-economic status and low maternal age affect pre-eclampsia disease distribution coupled with adverse pregnancy outcomes more in rural than urban areas. The better the socio-demographic conditions, the lower the disease distribution with good pregnancy outcomes. However, worsening maternal socio-demographic conditions may increase the incidence of pre-eclampsia among pregnant women of northern Zambia. The study recommended interventions tarred towards public health programmes such as social behaviour change and communication (SBCC) towards adolescent women and socio-economic empowerment of pregnant women in resource-limited areas. Keywords: Average ANC timing, Preeclampsia, Residency, Socio-economic, Teenage pregnancy.

scholarly journals Changes in serum TG levels during pregnancy and their association with postpartum hypertriglyceridemia: a population-based prospective cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yandi Zhu ◽  
Haiyan Zhu ◽  
Qinyu Dang ◽  
Qian Yang ◽  
Dongxu Huang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Blood Lipid ◽  
Roc Curves ◽  
Population Based ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Adverse Pregnancy ◽  
Stratified Analysis ◽  
Over Time

Abstract Background Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. However, some adverse pregnancy outcomes are thought to be related to gestational lipid levels. Therefore, it is necessary to have a reference range for lipid changes during gestation. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters. Methods A total of 908 pregnant women were followed from recruitment to 42 days postpartum, and their serum lipids were collected at gestational weeks 6–8, 16, 24, and 36 and 42 days postpartum. The major outcome was postpartum hypertriglyceridemia. The association between gestational and postpartum TG levels was analysed by stepwise multiple linear regression. A two-stage approach including a linear mixed-effect model and linear or logistic regression was conducted to explore the contribution of the changes in TG over time in pregnancy to postpartum hypertriglyceridemia. Logistic regression was constructed to examine the association between gestational TG levels and postpartum hypertriglyceridemia. Cut-off points were calculated by receiver operating characteristic (ROC) curves. Results There was a tendency for serum TG to increase with gestational age and decrease at 42 days postpartum. Prepregnancy overweight, obesity, and GDM intensified this elevation. Higher TG levels at gestational weeks 6–8, 16, 24, and 36 were positively associated with a higher risk of postpartum hypertriglyceridemia [OR 4.962, 95 % CI (3.007–8.189); OR 2.076, 95 % CI (1.303–3.309); OR 1.563, 95 % CI (1.092–2.236); and OR 1.534, 95 % CI (1.208–1.946), respectively]. The trend of the change in TG over time was positively associated with the TG level and risk of postpartum hypertriglyceridemia [OR 11.660, 95 % CI (6.018–22.591)]. Based on ROC curves, the cut-off points of serum TG levels were 1.93, 2.35, and 3.08 mmol/L at gestational weeks 16, 24, and 36, respectively. Stratified analysis of prepregnancy body mass index (pre-BMI) and GDM showed that higher gestational TG was a risk factor for postpartum hypertriglyceridemia in women with normal pre-BMI and without GDM. Conclusions Gestational TG and its elevation were risk and predictive factors of postpartum hypertriglyceridemia, especially in pregnant women with normal pre-BMI or without GDM.

scholarly journals Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahimeh Ranjbar ◽  
Leila Allahqoli ◽  
Soheila Ahmadi ◽  
Robab Mousavi ◽  
Maryam Gharacheh ◽  
...  
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Health Care Services ◽  
Mode Of Delivery ◽  
Preterm Births ◽  
Future Health ◽  
Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

Prenatal oral health literacy status: a survey on patient’s perception and awareness among health care professionals

2017 ◽  
Vol 9 (2) ◽  
pp. 16-22
Author(s):  
Sandya Devi S Patil ◽  
Madhu K ◽  
Rachna Thakur ◽  
Santhosh T Paul ◽  
Mihir Nayak
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Health Care Professionals ◽  
Oral Care ◽  
Oral Health Care ◽  
Attitude And Practice ◽  
Group A ◽  
Adverse Pregnancy

Pregnancy is characterized by complex physiological changes which may adversely affect the oral health and pregnancy outcomes. This study reports a survey on assessing the knowledge, attitude and practice behaviours of gynaecologists and oral health care professionals towards prenatal oral care and barriers limiting the utilization of prenatal oral care health care to pregnant women. The study population comprised of 3 groups: A- Gynaecologists, B- oral health care professionals and C – Pregnant women, 100 in each group. The prevalidated questionnaire included questions about their knowledge, attitude, beliefs and practices regarding oral health care for pregnant women. The data obtained was subjected to statistical analysis using ANOVA test and Pearson’s correlation test. The response rate was 100%. Regarding the association of periodontal disease and adverse pregnancy outcomes, Group A (75%) have high degree of knowledge than B (61%) and C (36%) but the attitude and practice behaviors were significantly high in Group B as compared to Group A and Group C Two-thirds of respondents in both Group A and B (75%) were interested in receiving continuing dental education (CDE) regarding the care of pregnant women.The self-assessed maternal barriers evaluated in this study were lack of knowledge, lack of perceived need.

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