A neonatologist at Riley Children’s Health teamed up with researchers at Indiana University School of Medicine and Kenyan investigators from Moi University School of Medicine to analyze maternal sepsis, one of the world’s leading causes of maternal death. The study, known as A-PLUS and conducted by the Global Network for Women’s and Children’s Health Research, will decrease the formation of the diagnosis and its mortality rates by a third, thanks to the recent discovery of the antibiotic azithromycin.
Sepsis, often referred to as blood poisoning, is a life-threatening disease that results from an infection in the body and requires immediate treatment. While maternal sepsis is most evident in developing countries, azithromycin will likely reduce maternal infection and the likeliness of mortality when given during a cesarean delivery. In response, this investigation will potentially save thousands of mothers’ lives, according to Fabian Esamai, MBChB, MMed, MPH, PhD of Moi University.
The Indiana-based team consisted of Osayame Ekhaquere, MD, MPH, pediatric neonatologist at Riley Children’s, and Sherri Bucher, PhD, MA, associate professor of pediatrics at IU School of Medicine. Alongside Moi University, they stewarded a site led at the University of Alabama-Birmingham. Combining their site-specific research with seven other sites from countries around the world, researchers concluded that only 1.6% of women in the study who received azithromycin developed sepsis or died within six weeks after delivery. Results also showed fewer hospital readmissions and healthcare visits thereafter.
“These findings have the potential to change clinical practice by providing a safe, effective and low-cost approach to reduce the global burden of maternal sepsis and death,” Diana W. Bianchi, MD said, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. “We urgently need effective strategies to prevent pregnancy-related infections, which account for roughly 10% of maternal deaths worldwide.”
“No baby should ever be left motherless for lack of access to basic medications,” Dr. Bucher added. “Through this study and others like it, we know these interventions save lives, but moving from knowledge to implementation will be the next challenge.”
The U.S. site involved 3,673 participating mothers, and additional collaborating sites included mothers from Bangladesh, the Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan and Zambia, totaling 29,000 participants overall. Co-funded by the Bill & Melissa Gates Foundation through a grant to the National Institutes of Health, the study is highlighted in a February publication of the New England Journal of Medicine.
A-PLUS also includes a sub-study to examine antimicrobial resistance and maternal or neonatal microbiome. Here, global investigators will seek additional data to determine if the administration of a two-gram dose of azithromycin should become the standard labor treatment for mothers in low and middle-income countries.
Still, it is the strong collaboration between Indiana and its global partnerships that allowed the research to progress as it did. “Complex studies such as A-PLUS are only possible through long-term, sustainable partnerships such as the relationship IU and Moi University have created through AMPATH Kenya and the Global Network,” Dr. Ekhaquere said. “Our combined scientific knowledge is one step closer to diminishing maternal mortality globally.”
Neonatologists at Riley Children’s drive research and deliver top-notch care to examine cases like maternal sepsis. Learn more about the expert neonatology department at Riley Children’s.