Looking beyond the numbers: quality assurance procedures in the Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry
Background
The World Health Organization (WHO) defines a neonatal death as the death of a live born infant during the first 28 days of life. Of 5.7 million under-five deaths that occur annually, approximately 47% occur in the first 28 day. Disparities in the 28-day neonatal mortality rate (NMR) exist across and within countries. The NMR is much higher in resource constrained countries than in well-resourced countries, although exceptions exis. Babies with a birthweight ≥ 2500 g account for more than 80% of the births in most resource limited locations, and often account for nearly half of the neonatal death. Because of the continuing focus on preterm and low-birthweight births, which are higher risk but account for only about half the neonatal deaths, information on mortality for babies born with a birth weight of ≥ 2500 g is limited. Knowledge regarding the trends and factors associated with mortality in these babies will help in identifying interventions that can result in lower mortality.
In many high-resource settings, substantial improvements have been made in neonatal outcomes, with deaths in babies with a birth weight of ≥ 2500 g substantially reduce. For example, in 2015 in Europe, 94%–95% of births were ≥ 2500 g and these births accounted for 24% of the neonatal mortalit. In low-resource settings, the mortality among these infants is still substantially higher than observed in high-resource settings. Thus, while infants born < 2500 g have a higher risk of neonatal mortality compared to those ≥ 2500 g, because most of the births are ≥ 2500 g, these births potentially represent a large proportion of the potentially preventable deaths in low-resource setting.
The Maternal Newborn Health Registry (MNHR) of the Global Network for Women’s and Children’s Health Research (Global Network) is a pregnancy registry conducted in sites in low-resource countries in south Asia, sub-Saharan Africa and Central America. The MNHR data demonstrates high neonatal mortality rates across the participating surveillance sites of member countries. Overall, the MNHR data show slowly improving but continuing high maternal and neonatal mortality rates over the years across all Global Network sites. We sought to explore the trends and factors associated with mortality in babies born with a birth weight of ≥ 2500 g. These infants are generally term or late preterm and the overwhelming majority can survive with usual obstetric and newborn care.
By: Garces A, MacGuire E, Franklin HL, Alfaro N, Patel A, Goudar SS et al.