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 defned 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 ofspring, sociodemographic, health care, and the major out‑
comes 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 diferences 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 under‑
standing 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, populationbased registry, assesses pregnancy outcomes over time in support of eforts to develop improved perinatal healthcare
in resource-limited areas.