STUDY SHOWS ANTIBIOTIC REDUCES MOTHERS’ RISK OF DEATH DURING, AFTER CHILDBIRTH
Asingle dose of the antibiotic azithromycin can help protect mothers from dangerous sepsis infections and death during vaginal childbirth, a sweeping new international study from a UVA Health scientist and his collaborators has found.Azithromycin, also known as Z-Pak, has already been shown to benefit women delivering by cesarean section. But the new findings reveal that the common antibiotic reduces mortality for women delivering vaginally and cuts their risk of developing sepsis, a potentially fatal full-body infection.
Infections, particularly sepsis, are responsible for 10% of maternal deaths shortly before, during and after childbirth, putting such infections in the top five causes of maternal mortality worldwide.“A single dose of the antibiotic azithromycin decreased sepsis and death by half in women in labor,” said researcher Dr. William A. Petri Jr., of the University of Virginia School of Medicine’s Division of Infectious Diseases and International Health. “The simplicity of this intervention should allow its institution around the globe to protect mothers during childbirth.”Petri is part of the Azithromycin Prophylaxis in Labor Use Study (A-PLUS) Trial Group, an international coalition of researchers that set out to determine if giving the antibiotic during childbirth would benefit either mothers or their children. More than 29,000 women in low- and middle-income countries volunteered to take part in the randomized trial; half were given azithromycin and half were given a harmless placebo.Among the 14,637 women who received the placebo, 2.4% developed sepsis or died within six weeks. That’s compared with only 1.6% of the 14,526 women who received azithromycin. The difference was clear enough that the researchers stopped the trial early.
The antibiotic did not provide similar benefits for the babies, the researchers found. However, they say that benefits for the mothers, combined with the lack of harmful side effects, makes azithromycin an important new tool for keeping moms safe before, during and after delivery. The antibiotic is already recommended for caesarian births in the United States and elsewhere.
UVA is one of seven universities participating in the Global Network for Women’s and Children’s Health, which is supported by a grant from the National Institute of Child Health and Human Development. Network research supports and conducts clinical trials in resource-limited countries by pairing foreign and U.S. investigators, with the goal of evaluating low-cost, sustainable interventions to improve maternal and child health and simultaneously building local research capacity and infrastructure.
The network team at UVA includes Petri, Drs. Chris Chisholm (Obstetrics/Gynecology), Rob Sinkin (Pediatrics), Chelsea Braun (Medicine/Infectious Diseases), and program manager Lauren Swindell. In Bangladesh, members include Drs. Rashidul Haque and Masum Billah of the Bangladeshi research center officially named “icddr,b” and Ruth Lennox of Bangladesh’s LAMB Hospital.
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