Antibiotics can Save Mothers During Childbirth

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Highlights:

• Sepsis is a life-threatening complication of bacterial and other infections and is the leading cause of maternal deaths globally, especially in low- and middle-income countries
• Azithromycin is an inexpensive antibiotic effective against a broad range of bacteria
• A single oral dose of the antibiotic azithromycin can reduce the risk of postpartum sepsis and death among women who deliver vaginally by one-third

Mothers bring life into the world. However, death of mothers during childbirth by sepsis is a grave concern. A single dose of the antibiotic azithromycin can help protect mothers from dangerous septic infections and death during vaginal childbirth, according to a new international study from a UVA Health scientist and his collaborators.

Azithromycin has already been shown to benefit women delivering by cesarean section. However, 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.

‘A single dose of azithromycin can prevent death of mothers during child birth’

Sepsis is responsible for 10% of maternal deaths shortly before, during, and after childbirth. This puts 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 William A. Petri Jr., MD, PhD, of the University of Virginia School of Medicine's Division of Infectious Diseases and International Health. "The simplicity of this intervention should allow its institutions around the globe to protect mothers during childbirth."

Azithromycin can Save Mothers' Lives During Delivery

Researchers 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 of the women were given azithromycin and the other 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.

Researchers found that the antibiotic did not provide similar benefits for the babies. 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 cesarean births in the United States and elsewhere.

Importance of Improving Maternal Care

The researchers noted that the findings result from an important collaboration of scientists around the world working together to improve care for pregnant women and help them deliver their babies more safely.

"All of us engaged in the work of the network here in Charlottesville are enjoying the opportunity to collaborate across disciplines, each of us enriched by the perspectives of obstetricians, pediatricians, and infectious-disease specialists," Petri said. "The network is open to all to propose new multi-site international studies in maternal and child health, and I hope that innovative ideas and ultimately clinical trials will originate here at UVA."

Reference:

1. Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth - (https:pubmed.ncbi.nlm.nih.gov/36757318/)

Source: Medindia

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