In low-and-middle income countries, pregnancy-related infections are a major cause of maternal death, can also be fatal to unborn and newborn babies, and are mostly caused by four types of conditions that are treatable and preventable, according to a review by US researchers published in this week's PLOS Medicine.
The authors, led by Michael Gravett and a team of investigators from the University of Washington in Seattle, PATH (Program for Appropriate Technology in Health), and GAPPS (Global Alliance to Prevent Prematurity and Stillbirth, Seattle Children's) reviewed all published studies with information about maternal infections, paying particular attention to studies from Africa and Asia (where most--80%--of global maternal deaths occur), in order to identify appropriate strategies for detecting infections and providing effective interventions. They found that most life-threatening pregnancy-related infections are caused by infections of the genital tract, urinary tract, soft tissues, and infections related to abortion.
The authors recommend that interventions targeting each type of infection be integrated into antenatal care services, especially at the first visit and also at the onset of labor. They also advocate for affordable diagnostic tests and treatment to be provided to pregnant women at the clinic on the one visit (point-of-care), and for improved data collection on the types of organisms causing pregnancy-related infections.
The authors say: "Our review identified four clinical syndromes, and microbes associated with them, that appear to be responsible for most cases of life-threatening pregnancy related infections in low-and-middle-income countries."
They continue: "Each of these occurs at a distinct time during pregnancy, providing opportunities for screening and prevention."
The authors add: "There is a great need for comprehensive studies in low-and-middle-income countries exploring the epidemiology, risk factors, and microbiology of life-threatening maternal infections."
They conclude: "Without such data, women will continue to be treated inappropriately and experience potentially preventable mortality and morbidity."
Funding: Preparation of this manuscript was made possible with the support of the Bill & Melinda Gates Foundation, http://www.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Gravett CA, Gravett MG, Martin ET, Bernson JD, Khan S, et al. (2012) Serious and Life-Threatening Pregnancy-Related Infections: Opportunities to Reduce the Global Burden. PLoS Med 9(10): e1001324. doi:10.1371/journal.pmed.1001324
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Michael G. Gravett
Global Alliance to Prevent Prematurity and Stillbirth
Seattle Children's, Seattle, Washington
United States of America