Study: Four Treatable Conditions Cause Most Pregnancy-Related Infections

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Pregnancy-related infections are one of the leading causes of death among pregnant women in low- and middle-income countries — but most of these infections are treatable and preventable, researchers say.

In a recent review, U.S. researchers identified four conditions responsible for the majority of pregnancy-related infections, which can also be fatal for fetuses and newborn babies: infections of the genital tract, soft tissues or urinary tract, or abortion-related infections. Each problem occurs at a distinct point during pregnancy and can be prevented, the authors say.

The Seattle researchers reviewed studies related to maternal infections published between 1980 to 2012, paying close attention to studies in Africa and Asia where 80% of maternal deaths occur. Puerperal sepsis, identified as a common genital tract infection, is responsible for 10% to 12% of maternal deaths and can be intercepted at a patient’s first visit and again before labor and delivery (when it most commonly occurs).

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Septic abortion is another common complication due to infections contracted during unsafe abortions. The World Health Organization (WHO) estimates that 21.6 million unsafe abortions occur yearly.

With screening and follow-up antibiotics, all the conditions can be treated, and serious pregnancy and birth complications can be avoided.

Based on their review, the authors report that there is a significant gap in knowledge in detecting and preventing infections among pregnant women in low- and middle-income countries. Increased awareness of such infections, and an improved capacity to identify and treat them is especially important in these countries where many births occur at home or in community clinics.

The authors recommend that physicians intervene to diagnose and treat infections at two points during a woman’s pregnancy: at the woman’s first prenatal visit and at the onset of labor. “These two time points represent the periods of highest disease occurrence for life-threatening maternal infections, and therefore the times when screening, diagnosis and treatment are most critical,” they write.

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They also recommend “bundling” interventions and testing for all four complications at once in order to cast a wide net and identify and treat infections early and promptly.

The authors cite a need for more affordable diagnostic tools and treatments as well as further research into the microbiology and risk factors of life-threatening maternal infections in low- and middle-income countries. “Without such data, women will continue to be treated inappropriately and experience potentially preventable mortality and morbidity,” they conclude.

The review is published in the journal PLOS Medicine.

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