Antibiotics during pregnancy may reduce preterm births in women with HIV: Study

New Delhi, June 6 A daily dose of a commonly used, safe, and inexpensive antibiotic may help reduce preterm births (born at 37 weeks’ gestation or before), in women with HIV, according to a study of almost 1,000 pregnant women in Zimbabwe.

An international group of researchers, from the UK and Zimbabwe, found that women living with HIV who took the antibiotic trimethoprim–sulfamethoxazole during their pregnancy had larger babies who were less likely to be preterm.

Trimethoprim–sulfamethoxazole is a broad-spectrum antimicrobial agent with anti-inflammatory properties that are widely used in sub-Saharan Africa.

The study showed that for babies born to a small group of 131 women with HIV, the reduction in premature births was especially marked, with only 2 per cent of births in the trimethoprim–sulfamethoxazole group preterm, as compared with 14 per cent in the placebo group.

“Our findings suggest that a low-cost, daily antibiotic, in a setting where infections like HIV are common, might reduce the risk of preterm births. We desperately need new strategies to prevent preterm births, which are the leading cause of under-5 child mortality,” said Andrew Prendergast, Professor of Paediatric Infection and Immunology at Queen Mary University of London.

“If we can confirm in other trials that trimethoprim-sulfamethoxazole reduces the risk of babies being born too soon, it would be a promising new approach to help newborns survive and thrive,” he added.

One in four live-born infants worldwide is preterm, is small for gestational age, or has a low birth weight.

The mortality rate for these small and vulnerable newborns is high, with prematurity now the leading cause of death among children younger than 5 years of age.

Maternal infections and inflammation during pregnancy are linked to adverse birth outcomes, particularly for babies born to mothers living with HIV, who have a greater risk of being born too small or too soon.

The randomised controlled trial included 993 pregnant women from three antenatal clinics in central Zimbabwe, and gave them either 960 mg of the drug or a placebo daily.

The study, published in the New England Journal of Medicine, found that although birth weight did not differ significantly between the two groups, the trimethoprim–sulfamethoxazole group showed a 40 per cent reduction in the proportion of preterm births, compared to the placebo group.

Overall, 6.9 per cent of mothers receiving the drug had babies born preterm, compared to 11.5 per cent of mothers receiving the placebo, and no women receiving antibiotics had babies born before 28 weeks.

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