Health
A single dose of a common antibiotic given during labor reduces the risk of maternal death or sepsis
Sepsis – a severe infection in the body that can lead to tissue damage, organ failure and death – is one of the leading causes of maternal death worldwide, according to the World Health Organization (WHO). This is a life-threatening emergency, largely preventable with early diagnosis and treatment, and can disproportionately affect pregnant women in low- and middle-income countries. WHO has identified reducing maternal deaths, including deaths from sepsis, as a top global health priority.
New research presented today at the Society for Maternal and Fetal Medicine (SMFM) Annual Meeting is featured in The Pregnancy Meeting™ -; American Journal of Obstetrics and Gynecology — Researchers will reveal findings suggesting that a single dose of azithromycin significantly reduced the risk of maternal death or sepsis in women planning a vaginal birth.
The randomized controlled trial included 29,278 participants at eight Eunice Kennedy Shriver sites.
National Institute of Child Health and Human Development (NICHD) Global Network for Women and Child Health Research in Africa (Democratic Republic of the Congo, Kenya and Zambia); Asia (2 sites in Bangladesh, Pakistan and India); and Latin America (Guatemala).
Participants were randomized to receive either azithromycin. It is a popular low-cost antibiotic used to treat a variety of bacterial infections and is included on the WHO list of essential medicines. or placebo. All participants were at least 28 weeks pregnant with planned vaginal deliveries at a medical facility.
Overall, 14,590 received azithromycin and 14,688 received placebo. All participants were followed for 42 days after delivery to ensure consistency with the WHO definition of maternal mortality, including death during pregnancy and within 42 days after delivery.
Researchers found that a single dose of orally administered azithromycin reduced the risk of maternal death or sepsis by 33% in women who delivered vaginally. In addition, researchers found several secondary findings, including fewer readmissions and emergency visits in patients who received azithromycin.
“International organizations have identified deadly severe maternal infections as a major global health problem, especially in developing countries, and little progress has been made over time,” said the study’s lead author. Author Alan Thevenet N. Tita, MD, PhD. He is a medical sub-specialist at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine and has held multiple positions including associate dean of global and women’s health. Mary Heersink is Endowed Chair of Global Health and Director of her Institute for Global Health. She is the director of the University-Wide Interdisciplinary Center for Women’s Reproductive Health.
“We wanted to reduce the burden of maternal infections in a predominantly vaginal delivery population. It shows that it can be a useful and low-cost intervention to reduce
This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institutes of Health Foundation (through a grant from the Gates Foundation).
A complete study New England Journal of Medicine today.
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Journal reference:
Tita, ATN, and others. (2023) Azithromycin for preventing sepsis or death in women planning vaginal delivery. New England Journal of Medicine. doi.org/10.1056/NEJ Moa2212111.
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