Effect of prenatal and perinatal antibiotics on maternal health in Malawi, Tanzania, and Zambia.
OBJECTIVE
We assessed the effect of prenatal and peripartum antibiotics on maternal morbidity and mortality among HIV-infected and uninfected women.


METHODS
A multicenter trial was conducted at clinical sites in 4 Sub-Saharan African cities: Blantyre and Lilongwe, Malawi; Dar es Salaam, Tanzania; and Lusaka, Zambia. A total of 1558 HIV-infected and 271 uninfected pregnant women who were eligible to receive both the prenatal and peripartum antibiotic/placebo regimens were enrolled. Pregnant women were interviewed at 20-24 weeks of gestation and a physical examination was performed. Women were randomized to receive either antibiotics or placebo. At the 26-30 week visit, participants were given antibiotics or placebo to be taken every 4 hours beginning at the onset of labor and continuing after delivery 3 times a day until a 1-week course was completed. Logistic regression and Cox proportional hazards models were used.


RESULTS
There were no significant differences between the antibiotic and placebo groups for medical conditions, obstetric complications, physical examination findings, puerperal sepsis, and death in either the HIV-infected or the uninfected cohort.


CONCLUSIONS
Administration of study antibiotics during pregnancy had no effect on maternal morbidity and mortality among HIV-infected and uninfected pregnant women.
Aboud
Said
S
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. aboudsaid@yahoo.com
Msamanga
Gernard
G
Read
Jennifer S
JS
Wang
Lei
L
Mfalila
Chelu
C
Sharma
Usha
U
Martinson
Francis
F
Taha
Taha E
TE
Goldenberg
Robert L
RL
Fawzi
Wafaie W
WW
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008295:Malawi; D008428:Maternal Mortality; D008429:Maternal Welfare; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000517:prevention & control; D016017:Odds Ratio; D018743:Perinatal Care / Q000379:methods*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011645:Puerperal Infection / Q000453:epidemiology / Q000517:prevention & control*; D013636:Tanzania; D055815:Young Adult; D015024:Zambia
D000900:Anti-Bacterial Agents