Interventions to Prevent and Manage Infections in Pregnancy.

Neonatology Pub Date : 2025-01-01 Epub Date: 2025-01-28 DOI:10.1159/000543690
Rahima Yasin, Li Jiang, Jai K Das, Zulfiqar A Bhutta
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Abstract

Background: Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.

Summary: We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and lower-middle-income countries (LMICs) for outcomes relevant to neonatal health. Findings from our papers indicate limited evidence from LMICs, highlighting the pressing need for coordinated efforts to close this gap and strengthen the body of inclusive evidence on prevention and treatment of maternal infections during pregnancy.

Key messages: Evidence from LMICs suggests that influenza virus vaccination had no effect on stillbirth, preterm birth, small for gestational age, or low birthweight (LBW). Insecticide-treated bed nets in pregnancy reduced the risk of fetal loss and improved the babies' birthweight. Changing a two-dose intermittent preventive treatment (IPTp) regimen to more frequent IPTp dosing decreased the risk of LBW and significantly improved babies' birthweight. Addition of antibacterial antibiotic to the IPTp regimen significantly reduced the risk of LBW. Antibiotic treatments for syphilis and chlamydia had a significant effect on LBW. Treatment of documented periodontal disease during pregnancy reduced the risk of LBW.

Background: Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.

Summary: We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and lower-middle-income countries (LMICs) for outcomes relevant to neonatal health. Findings from our papers indicate limited evidence from LMICs, highlighting the pressing need for coordinated efforts to close this gap and strengthen the body of inclusive evidence on prevention and treatment of maternal infections during pregnancy.

Key messages: Evidence from LMICs suggests that influenza virus vaccination had no effect on stillbirth, preterm birth, small for gestational age, or low birthweight (LBW). Insecticide-treated bed nets in pregnancy reduced the risk of fetal loss and improved the babies' birthweight. Changing a two-dose intermittent preventive treatment (IPTp) regimen to more frequent IPTp dosing decreased the risk of LBW and significantly improved babies' birthweight. Addition of antibacterial antibiotic to the IPTp regimen significantly reduced the risk of LBW. Antibiotic treatments for syphilis and chlamydia had a significant effect on LBW. Treatment of documented periodontal disease during pregnancy reduced the risk of LBW.

预防和管理妊娠期感染的干预措施。
前言:旨在预防和治疗妊娠期孕产妇感染的干预措施至关重要。及时的免疫接种、筛查策略和孕产妇感染管理可降低发育中的胎儿出现并发症的风险,并在改善新生儿结局方面发挥关键作用。摘要:我们总结了来自2014年《柳叶刀》发表的《每个新生儿系列》的13项干预措施的证据,这些措施与产前期间孕产妇感染的预防和治疗有关。我们确定了最新的系统综述,从每个综述中提取数据,并对低收入国家(lic)和中低收入国家(LMICs)进行了亚组荟萃分析,以了解与新生儿健康相关的结果。结果:来自低收入国家的证据表明,流感病毒疫苗接种对死胎、早产、小胎龄(SGA)或低出生体重(LBW)没有影响。怀孕期间使用经杀虫剂处理的蚊帐(ITN)降低了胎儿丢失的风险,并改善了婴儿的出生体重。将两剂间歇预防治疗(IPTp)方案改为更频繁的IPTp剂量可降低LBW的风险,并显着改善婴儿的出生体重。在IPTp方案中加入抗菌抗生素可显著降低LBW的风险。抗生素治疗梅毒和衣原体对LBW有显著影响。在怀孕期间治疗有记录的牙周病可降低LBW的风险。我们论文的研究结果表明,来自中低收入国家的证据有限,这突显了迫切需要协调努力,以缩小这一差距,并加强有关预防和治疗妊娠期间孕产妇感染的包容性证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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