Common antibiotics can prevent death from birth complications

Childbirth is a traumatic experience, both emotionally and physically. Childbirth, whether by vaginal delivery or caesarean section, creates opportunities for bacteria to infect both the parent and the newborn, and sometimes these infections can cause the parent’s immune response to go out of control.

Its extreme reaction to infection, called sepsis, third most Global cause of death during or after childbirth. millions of maternal sepsis occur each year, mainly in low- and middle-income countries. The usual symptoms of sepsis, such as fever, rapid heart rate, and low blood pressure, can appear even during healthy pregnancies and births, making it particularly difficult for doctors to detect and treat in time. . Left untreated, sepsis can lead to tissue damage, organ failure, and ultimately death.

To prevent these infections during a caesarean section, doctors routinely give an antibiotic called azithromycin before starting the operation.A global study in low- and middle-income countries now shows that the same approach may also prevent sepsis in vaginal deliveries. A single dose of azithromycin for those planning a vaginal delivery Reduced risk of sepsis by 35%Because azithromycin is inexpensive and can be taken orally, this approach prevents some cases of maternal sepsis in countries with limited access to healthcare, where sepsis during or after childbirth is more common. It may be a viable method. Results published Thursday New England Journal of Medicine.

The study “is a very exciting story because it adds to our ability to care for these women better and ultimately change the outcome,” he said. Laura RileyDepartment of Obstetrics and Gynecology, Weill Cornell Medicine, New York City, was not involved in the study.

The study followed approximately 30,000 participants from seven countries: Bangladesh, India, Pakistan, Zambia, Kenya, Democratic Republic of the Congo, and Guatemala. Researchers followed the participants for over a month after giving birth. His 1.6% of participants who received antibiotics experienced sepsis compared with 2.5% of him who received no treatment. This was a larger reduction than expected by the study’s architects, and participants experienced minimal side effects. Antibiotics had no effect on neonatal infection or mortality rates.

say “we were excited” Alan Tita, Department of Obstetrics and Gynecology, University of Alabama, Birmingham, and lead author of the study. “It’s great because it can make a big difference in patient care and outcomes.” The research team had planned to enroll more participants, but early results pushed the study forward. was decisive enough to end in

“It’s been a very pleasant surprise to see such a large effect,” he says. Michael Santos One of the funding partners for this study is the National Institutes of Health Foundation. “That’s a really nice result.”

If a person survives sepsis, it can cause lifelong damage.

Fortunately, sepsis is often preventable. “I think research alone is enough to change practice,” he says. Lindsey Admon, an obstetrician-gynecologist studying health equity at the University of Michigan, was not involved in the study. Maternal mortality in the United States is Increased since late 1990s and that’s it double height As in other wealthy countries.Racial inequality is high here, with blacks three times more likely To die in childbirth as a white, according to the Centers for Disease Control and Prevention. Admon hopes similar studies will be done in the United States and other high-income countries, but there are still large health disparities.

However, the benefits of prescribing azithromycin for sepsis prevention must be weighed against the consequences of antibiotic overuse. Let them find ways to avoid bacteria. Increasing number of drug-resistant bacteria, and they can be fatal. Azithromycin in particular targets a wide range of bacteria, making it effective in childbirth. This trade-off is crucial in weighing the benefits of this intervention, said Mercedes-Bonnet-Semenas, a World Health Organization medical officer. Department of Sexual and Reproductive Health and Researchwas not involved in the new paper.

“That question was on everyone’s mind and was part of the research plan,” says Santos. The researchers continue to analyze samples taken from participants to determine the drug’s exact effects on naturally occurring bacteria in patients’ bodies, and they expect these results to be published in his 2024 publication. I hope you will.

Preventing sepsis may be worth the risk of contributing to antibiotic resistance in parts of the world where infections during birth are common. Julie Gerberding CEO of the National Institutes of Health Foundation. A global and coordinated effort is needed to get medicines to those who can use them most. WHO can review the results and choose to include the treatment in its regimen. Essential Drug Programand Obstetric Care Guidelines and Gerberding says.

Maternal mortality is “an area of ​​high inequality,” she says. “Now this is our chance to tackle a very dangerous aspect of birth.”