Category: Obstetrics & Gynaecology

Categories : Obstetrics & GynaecologyTags :

Big Data Begins to Crack the Puzzle of Endometriosis

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Photo by Sora Shimazaki on Pexels

Scientists at UC San Francisco have found that endometriosis, a painful chronic disease that often goes undiagnosed yet is estimated to affect as many as 200 million women worldwide, frequently occurs alongside conditions like cancer, Crohn’s disease, and migraine.

The research could improve diagnosis and, ultimately, treatments for endometriosis, preventing women from having to go on long diagnostic journeys in which they are told that nothing is wrong with them.

The study, which appeared in Cell Reports Medicine on July 31, used computational methods developed at UCSF to analyse anonymised patient records collected at the University of California’s six health centres.

“We now have both the tools and the data to make a difference for the huge population that suffers from endometriosis,” said Marina Sirota, PhD, the interim director of the UCSF Bakar Computational Health Sciences Institute (BCHSI), professor of pediatrics, and senior author of the paper. “We hope this can spur a sea change in how we approach this disorder.”

“The impact on patients’ lives is huge”

Endometriosis, often called ‘endo,’ occurs when the endometrium, the blood-rich tissue that grows in the uterus before being expelled each month during menstruation, spreads to other nearby organs. It causes chronic pain and infertility. It is estimated that nearly 10% of women worldwide suffer from it.

“Endo is extremely debilitating,” said Linda Giudice, MD, PhD, MSc, a physician-scientist in the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF and co-author of the paper. “The impact on patients’ lives is huge, from their interpersonal relationships to being able to hold a job, have a family, and maintain psychological wellbeing.”

The gold standard to diagnose endometriosis is surgery to find endometrial tissue outside of the uterus, and it is mainly treated with hormones to suppress the menstrual cycle, or surgery to remove the excess tissue.

But not everyone responds to hormonal therapy, which can have debilitating side effects. Even after surgery, the condition can flare up. Removal of the uterus is a last-ditch measure that is usually reserved for older women; but some women continue to experience pain even after a hysterectomy.

Giudice partnered with Sirota to leverage the UC health system’s anonymised patient data against endo, which can vary dramatically across patients. Both Giudice and Sirota are principal investigators at the UCSF-Stanford Endometriosis Center for Discovery, Innovation, Training and Community Engagement (ENACT).

“This data is messy; it was not collected for research purposes but for the real, human purpose of helping women who need care,” Sirota said. “We had the rare chance to rigorously assess how endometriosis presents across UCSF’s patient population and then ask whether these observations held true with patients seen at the other UC health centers.”

Data connects the dots for understanding endometriosis

Using algorithms developed for the task, Umair Khan, a bioinformatics graduate student in Sirota’s lab and first author of the paper, hunted for connections linking endometriosis with the rest of each patient’s health history.

He compared endo patients with patients who did not have it, and categorised the patients with endo into groups based on shared health histories. He mapped his findings from the UCSF data against the rest of the UC’s health data to see if they held up across California.

“We found over 600 correlations between endometriosis and other conditions,” Khan said. “These ranged from what we already knew or suspected, like infertility, autoimmune disease, and acid-reflux, to the unexpected, like certain cancers, asthma, and eye-related diseases.”

Some patients had migraines, bolstering previous studies suggesting that migraine drugs might help treat endometriosis.

“In the past, studies like this would have been nearly impossible,” said Tomiko Oskotsky, MD, an investigator at ENACT, associate professor in UCSF BCHSI, and co-author of the paper. “It was only 12 years ago that de-identified electronic health records became available at this scale.”

The study supports the growing understanding of endometriosis as a “multi-system” disorder – a disease arising from dysfunction throughout the body.

“This is the kind of data we need to move the needle, which hasn’t moved in decades,” Giudice said. “We’re finally getting closer to faster diagnosis and, eventually, we hope, tailored treatment for the millions of women who suffer from endometriosis.”

Source: University of California – San Francisco

Categories : Mental Health Obstetrics & GynaecologyTags :

Surrogates Have an Increased Risk of a Mental Illness Diagnosis

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People who are gestational carriers (or “surrogates”) appear more likely to be diagnosed with a new mental illness during and after pregnancy, according to new research from ICES, McGill University, and the Research Institute of the McGill University Health Centre. 

As the number of births by surrogacy increases, this is the first large study using Ontario-based health data to explore the mental health challenges faced by some surrogates. 

Despite guidelines requiring mental health screening, the researchers found that nearly 1 in 5 gestational carriers had a prior mental illness diagnosis before pregnancy—including some with serious conditions that may have made them ineligible to carry a pregnancy for someone else. 

“Our findings underscore the importance of adequate screening and counselling of potential gestational carriers before pregnancy about the possibility of a new-onset mental illness, or exacerbation of a prior mental-illness during or after pregnancy,” says lead author Dr. Maria Velez, an adjunct scientist at ICES, associate professor at McGill University, and scientist at the Research Institute of the McGill University Health Centre. 

The study, published in JAMA Network Open, included 767 406 births at more than 20 week’s gestation in Ontario, Canada between 2012 and 2021 among women without known mental illness before pregnancy. Comparison groups included 97.6% (748,732) who were conceived without assistance, 2.3% (17,916) by IVF and 0.1% (758) using gestational carriers. 

Gestational carriers were more likely to have previously given birth, resided in a lower-income area, and had higher rates of obesity and chronic hypertension. 

Adequate mental health support needed 

The incidence rate per 100 person-years of new-onset mental illness was 5.2 among non-gestational carriers with unassisted conception, 5.0 among non-gestational carriers who conceived by IVF, and 6.9 among gestational carriers. 

The findings were even more pronounced for mental illness that was newly diagnosed through an emergency department encounter or a hospitalisation, compared to an outpatient mental illness diagnosis. 

“Unfortunately, fewer than half of those who visit the emergency room for mental health concerns after childbirth receive timely follow-up care which leaves many, especially gestational carriers, at risk during a vulnerable period,” says Velez. 

The authors say that they hope this study will inform future guidelines that ensure adequate mental health support for gestational carriers during and after pregnancy. 

Source: ICES

Categories : Metabolic Disorders Obstetrics & GynaecologyTags :

How Obesity also Affects the Next Generation

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Study reveals why children of obese mothers are more likely to develop metabolic disorders

Metabolites – from the mother permanently reprogram Kupffer cells. This changes their function, causes liver cells (hepatocytes) to accumulate fat and ultimately leads to a fatty liver. The graphic was created with BioRender.com (http://BioRender.com). © Image: AG Mass/University of Bonn

Children born to obese mothers are at higher risk of developing metabolic disorders, even if they follow a healthy diet themselves. A new study from the University of Bonn published in the journal Nature offers an explanation for this phenomenon. In obese mice, certain cells in the embryo’s liver are reprogrammed during pregnancy. This leads to long-term changes in the offspring’s metabolism. The researchers believe that these findings could also be relevant for humans.

The team focused on the so-called Kupffer cells. These are macrophages that help protect the body as part of the innate immune system. During embryonic development, they migrate into the liver, where they take up permanent residence. There, they fight off pathogens and break down ageing or damaged cells.

“But these Kupffer cells also act as conductors,” explains Prof Dr Elvira Mass from the LIMES Institute at the University of Bonn. “They instruct the surrounding liver cells on what to do. In this way, they help ensure that the liver, as a central metabolic organ, performs its many tasks correctly.”

Changing the tune: From Beethoven to Vivaldi

It appears, however, that it is this conducting function that is changed by obesity. This is what mouse experiments carried out by Mass in cooperation with other research groups at the University of Bonn suggest. “We were able to show that the offspring of obese mothers frequently developed a fatty liver shortly after birth,” says Dr Hao Huang from Mass’s lab. “And this happened even when the young animals were fed a completely normal diet.”

The cause of this disorder seems to be a kind of “reprogramming” of the Kupffer cells in the offspring. As a result, they send out molecular signals that instruct the liver cells to take up more fat. Figuratively speaking, they no longer conduct one of Beethoven’s symphonies but rather a piece by Vivaldi.

This shift already seems to occur during embryonic development and is triggered by metabolic products from the mother. These activate a kind of metabolic switch in the Kupffer cells and change the way these cells direct liver cells in the long term. “This switch is a so-called transcription factor,” says Mass. “It controls which genes are active in Kupffer cells.”

No fatty liver without the molecular switch

When the researchers genetically removed this switch in the Kupffer cells during pregnancy, the offspring did not develop a fatty liver. Whether this mechanism could also be targeted with medication is still unclear. The teams now plan to investigate this in follow-up studies.

If new treatment approaches emerge from this, it would be good news. The altered behaviour of the Kupffer cells likely has many negative consequences. Fat accumulation in the liver, for example, is accompanied by strong inflammatory responses. These can cause increasing numbers of hepatocytes to die and be replaced with scar tissue, resulting in fibrosis. At the same time, the risk that hepatocytes degenerate and become cancerous increases.

“It is becoming ever more evident that many diseases in humans already begin at a very early developmental stage,” says Mass, who is also spokesperson for the transdisciplinary research area “Life & Health” and a board member of the “ImmunoSensation2” Cluster of Excellence at the University of Bonn. “Our study is one of the few to explain in detail how this early programming can happen.”

Source: University of Bonn

Categories : Obstetrics & Gynaecology Skeletal SystemTags :

Stopping HRT Leads to a Period of Higher Fracture Risk for Most Women

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Photo by Mehmet Turgut Kirkgoz on Unsplash

A new study has found that the bone fracture protection women get from menopausal hormone therapy (MHT, also known as HRT) disappears within a year of stopping treatment.

In the new study, published in Lancet Healthy Longevity, experts from the School of Medicine at the University of Nottingham, also found that in most cases, stopping treatment is then followed by some years of elevated fracture risk compared to women who have never used MHT. Fracture risks then falls to be similar to, and then lower than women who have never used MHT.

The study was funded by the National Institute for Health and Care Research (NIHR) SPCR.

During menopause, all women experience a drop in hormone levels, particularly of oestrogen. This can cause a range of distressing mental and physical side effects, requiring use of MHT. However, oestrogen deficiency in women also leads to increased age-related bone weakening. Previous studies have confirmed a protective role of the oestrogen component in MHT treatments, and MHT is known to decrease fracture risk when it is being used.

However, MHT is also associated with increased risk of breast cancer and blood clots, so long-term MHT use is not recommended. For women using MHT to counteract increasing bone fragility, it is, therefore, important to know the strength and persistence of any protective effect after stopping treatment. Detailed information on this aspect from past studies has been unclear – covering only the first couple of years, and also being somewhat conflicting.

In this new study, experts used data for 6 000 000 women from around 2000 GP surgeries in the UK, which allowed them to follow-up of fracture risk levels for up to 25 years. The researchers identified all women with records of first fracture (cases) and matched each to a number of women of the same age and from the same practice, but without record of fracture (controls). They then compared the MHT use in cases before their fracture with the MHT use among their matched controls.

The findings of our study confirmed that women on MHT show a progressively reducing fracture risk compared with women not using MHT. More importantly, we also observed a clear pattern of risk change after therapy was discontinued. For most women, the bone protective effect of MHT use disappears completely within about one year of treatment being stopped, then their fracture risk rises compared to never users, peaking after about three years, before declining to become again equivalent to never users – about 10 years after discontinuation – and then again continuing to decline relative to never users. So, even after stopping MHT, women should benefit from notably reduced fracture risk in their later decades.”

Dr Yana Vinogradova, from the Centre for Academic Primary Care in the School of Medicine, and lead author of the study

This observed risk pattern was the same for all menopausal hormonal treatments, but the level of excess risk depended on the treatment type and the length of past MHT use.

“Our comparative illustration of observed patterns of fracture risk for short and long use can help doctors and patients when discussing MHT treatment options, and to consider how fracture risk may change after stopping MHT use. Anticipating periods of increased risk might prompt doctors to check patients’ bone health at discontinuation, particularly for patients most at risk with other fracture risk factors such as smoking or inactivity.

“These novel findings may also usefully stimulate further clinical and biological research into these treatments,” adds Dr Vinogradova.

Source: University of Nottingham

Categories : Obstetrics & Gynaecology VaccinesTags :

RSV Vaccination of Pregnant Mothers Reduces Infant Hospitalisations by 72%

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Researchers found the respiratory syncytial virus (RSV) vaccine, introduced across the UK in late summer 2024, led to a 72% reduction in babies hospitalised with the virus if the pregnant parent was vaccinated.

The findings, published in The Lancet Child and Adolescent Health, are the first to show the real-world effectiveness of the vaccine during pregnancy in the UK.

Uptake of the jab among those who are pregnant could help to limit the number of sick babies each winter, reducing hospital pressures, experts say. 

Virus protection

RSV is a common virus that causes coughs and colds but can lead to a severe lung infection called bronchiolitis, which can be dangerous in babies, with some requiring admission to intensive care. The virus is the main infectious cause of hospitalisation for babies in the UK and globally.

Receiving the vaccine during pregnancy helps to protect both parent and baby. Antibodies produced by the parent in response to the vaccine are passed to the foetus, providing protection from severe RSV for the first six months after birth.

Hospital admissions

The research team, led by the Universities of Edinburgh and Leicester, recruited 537 babies across England and Scotland who had been admitted to hospital with severe respiratory disease in the winter of 2024-2025, the first season of vaccine implementation. 391 of the babies tested positive for RSV. 

Parents of babies who did not have RSV were two times more likely to have received the vaccine before delivery than the parents of RSV-positive babies – 41% compared with 19%.

Vaccinate early

Receiving the vaccine more than 14 days before delivery offered a higher protective effect, with a 72% reduction in hospital admissions compared with 58% for infants whose pregnant parent was vaccinated at any time before delivery. 

Experts recommend getting vaccinated as soon as possible from 28 weeks of pregnancy to provide the best protection, as this allows more time for the parent to generate and pass on protective antibodies to the baby, but the jab can be given up to birth.

With the availability of an effective RSV vaccine shown to significantly reduce the risk of hospitalisation in young infants in the UK, there is an excellent opportunity for pregnant women to get vaccinated and protect themselves and their infants from RSV bronchiolitis this coming winter.

Dr Thomas Williams, Institute for Regeneration and Repair, Paediatric Consultant at the Royal Hospital for Children and Young People

Improve uptake

Previous research has found that only half of expectant parents in England and Scotland are currently receiving the RSV vaccine, despite its high success at preventing serious illness.

The findings highlight the importance of raising awareness of the availability and effectiveness of the new vaccine to help protect babies, experts say.

Source: The University of Edinburgh

Categories : Cancer Obstetrics & GynaecologyTags :

Breastfeeding’s Protective Effect Against Breast Cancer Explained by Metabolism

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Study shows a mother’s mitochondria determine if lactation is protective or not against breast cancer—and points to a possible intervention to increase the benefit to more women

Photo by Wendy Wei

Breastfeeding is often linked with better health for both mothers and babies, but it does not protect all women against breast cancer. The reason remains unknown. Since breast cancer in young women is on the rise, understanding why breastfeeding is protective in some women but not others is critical. 

A new study, led by a team of researchers from The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai and published in the journal Nature Communications, addressed this question. 

The study was performed in mice, which exhibit a similar phenomenon: lactation strongly protects some mice against breast cancer, but others are more susceptible. The researchers studied female mice that had the same basic DNA but different types of mitochondria. The team found that the way the body responds to breastfeeding could change depending on the mother’s mitochondria.  

In mice with specific types of mitochondria, the researchers found, lactation allowed a certain group of cells similar to those found in postpartum breast cancer in humans to expand and grow, explains Edmund Jenkins, PhD, Assistant Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine at Mount Sinai. Dr Jenkins served as the bioinformatics expert on the study. 

“We’ve always thought that breastfeeding is good for all women when it comes to lowering breast cancer risk,” said senior author Doris Germain, PhD, Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine at Mount Sinai. “But our study shows that it really depends on a woman’s metabolism and how her body responds to lactation at the cellular level.” 

The researchers also discovered that they could change the way the body reacts during breastfeeding by using a natural dietary supplement. In the mice that were at higher risk of developing postpartum breast cancer, this treatment switched their response from harmful to protective. This finding opens the door to a possible way to help more women benefit from breastfeeding by supporting their bodies in the right way.  

“Our research raises the possibility that one day, doctors might be able to identify women whose breastfeeding response puts them at risk and then offer them a simple, natural dietary intervention to change that,” said first author Mrittika Chattopadhyay, PhD, Assistant Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine at Mount Sinai. 

The team is now studying human breast milk with the goal of identifying milk metabolites that can show whether a woman’s body is reacting to breastfeeding in a way that is helpful or harmful. They also plan to develop a study in humans. One question then will be whether, because this dietary supplement may impact the development of the child, it should be tested only in mothers after they have stopped giving milk to their newborns.  

Source: Mount Sinai

Categories : Cardiovascular Disease Obstetrics & GynaecologyTags :

Premenstrual Symptoms Linked to Increased Risk of Cardiovascular Disease

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Women diagnosed with premenstrual symptoms have a slightly increased risk of developing cardiovascular disease later in life. This is shown by a new study from Karolinska Institutet published in Nature Cardiovascular Research.

Premenstrual symptoms include premenstrual syndrome (PMS) and the more severe form, premenstrual dysphoric disorder (PMDD). The symptoms, which appear a few days before menstruation and then subside, can be both psychological and physical.

The study included more than 99 000 women with premenstrual symptoms who were followed for up to 22 years. The researchers compared their health with women without these symptoms – both in the general population and by comparing them with their own sisters to take into account hereditary factors and upbringing.

The results show that women with premenstrual symptoms had about a ten per cent higher risk of developing cardiovascular disease. When the researchers also looked at different types of cardiovascular disease, they found that the link was particularly strong for heart rhythm disorders (arrhythmias), where the risk was 31 per cent higher, and for stroke caused by a blood clot, where the risk was 27 per cent higher. Even after the researchers took into account other factors such as smoking, BMI and mental health, the link between premenstrual symptoms and increased disease risk remained.

”The increased risk was particularly clear in women who were diagnosed before the age of 25 and in those who had also experienced postnatal depression, a condition that can also be caused by hormonal fluctuations,” says first author Yihui Yang, PhD student at the Institute of Environmental Medicine.

Research has not yet identified the cause of this link, but the researchers behind the study suggest three possible explanations. One is that women with premenstrual symptoms may have a disrupted regulation of the renin-angiotensin-aldosterone system (RAAS), which controls blood pressure and fluid balance in the body, among other things. The second is that these women have increased levels of inflammation in the body, which is a known risk factor for atherosclerosis and other heart problems. Finally, it may be because women with premenstrual symptoms may have metabolic abnormalities, which are linked to an increased risk of both stroke and heart attack.

”We hope that our findings will contribute to greater awareness that premenstrual disorders not only affect daily life but can also have consequences for long-term health,” says last author Donghao Lu, associate professor at the same department.

Source: Karolinska Institutet

Categories : Obstetrics & GynaecologyTags :

Age at Menarche Can Offer Clues About Long-term Health Risks

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Photo by Marta Branco

The age of menarche can offer valuable clues about a woman’s long-term risk for conditions like obesity, diabetes, heart disease and reproductive health issues, according to a study being presented Sunday at ENDO 2025, the Endocrine Society’s annual meeting in San Francisco.

The Brazilian study found that both early and late menarche – the age when women first get their period– are linked to different health risks. Women who had their first period before age 10 were more likely to develop obesity, hypertension, diabetes, heart problems and reproductive issues like pre-eclampsia later in life. Women who started their period after age 15 were less likely to be obese but had a higher risk of menstrual irregularities and certain heart conditions.

“We now have evidence from a large Brazilian population that confirms how both early and late puberty can have different long-term health impacts,” said study author Flávia Rezende Tinano of the University of Sao Paulo in Sao Paulo, Brazil. “While early menarche increases the risk for multiple metabolic and heart problems, late menarche may protect against obesity but increase certain heart and menstrual issues. Most women can remember when they had their first period, but they might not realise that it could signal future health risks. Understanding these links can help women and their doctors be more proactive about preventing conditions like diabetes, high blood pressure and heart disease.” 

Tinano said the study is one of the largest of its kind in a developing country, providing valuable data on a topic that has mostly been studied in wealthier countries. “It highlights how early and late puberty can affect a woman’s long-term health, especially in underrepresented populations like those in Latin America,” she said.

The study was part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil) and evaluated data from 7623 women ages 35 to 74. The age of their first period was categorised as early (less than 10 years old), typical (ages 10 to 15) or late (older than 15). They assessed the women’s health through interviews, physical measurements, lab tests and ultrasound imaging.

“Our findings suggest that knowing a woman’s age at her first period can help doctors identify those at higher risk for certain diseases,” Tinano said. “This information could guide more personalised screening and prevention efforts. It also emphasises the importance of early health education for young girls and women, especially in developing countries.”

Source: The Endocrine Society

Categories : Obstetrics & GynaecologyTags :

Helpful Hormone – Prolactin Helps Mothers Keep Cool During Pregnancy

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Otago researchers have found the hormone prolactin plays an important role in regulating body temperature during pregnancy. Credit: University of Otago

Prolactin supports milk production and stimulates caregiving behaviour in mothers, now a University of Otago – Ōtākou Whakaihu Waka study has found that this key pregnancy hormone also regulates body temperature during pregnancy.

Senior author Dr Rosie Brown, of the Department of Physiology, says adjusting body temperature is a critical function of the central nervous system and is vital to keep both mum and baby healthy.

The study, published in Cell Reports, has shown that prolactin acts within the brain’s hypothalamus to help regulate core body temperature throughout gestation.

“The body needs to function differently to cope during pregnancy – early on core body temperature rapidly elevates, likely because of rising progesterone levels, then increased metabolic heat occurs thanks to foetal growth, maternal tissue growth, and greater food intake,” Dr Brown says.

A mother must lose this extra metabolic heat both for herself and for her developing offspring.

“Despite all these thermal pressures, core body temperature actually reduces in late pregnancy, and we now know it is prolactin which helps keep a mum cool.

“This seems to be an important change to promote heat loss and to, ultimately, provide a safe environment for the foetus, as hyperthermia can impact brain development.”

Dr Brown says the finding provides better understanding of how the changing hormones of pregnancy and lactation act in the maternal brain to alter how the body functions and promote survival and wellbeing of a mother and her offspring.

“Obviously, that helps us understand what is happening at a cellular level during pregnancy, but understanding adaptable changes in body temperature in mammals may also be critical for animal reproduction in a world facing climate change.

“The prolactin pathway in the brain may be a mechanism that helps mammals adapt to future thermal challenges.”

Source: University of Otago

Categories : Antibiotics Obstetrics & GynaecologyTags :

Antibiotics Taken During Pregnancy May Reduce Preterm Births

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Photo by SHVETS production

A study of almost 1000 pregnant women in Zimbabwe found that a daily dose of a commonly used, safe and inexpensive antibiotic may have led to fewer babies being born early. Among women living with HIV, those who received the antibiotic had larger babies who were less likely to be preterm.

One in four live-born infants worldwide is preterm (born at 37 weeks’ gestation or before), 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. 

An international group of researchers, led by Professor Andrew Prendergast from Queen Mary University of London, and Bernard Chasekwa from the Zvitambo Institute for Maternal and Child Health Research in Zimbabwe, conducted the Cotrimoxazole for Mothers to Improve Birthweight in Infants (COMBI) randomised controlled trial, to examine whether prescribing pregnant women a daily dose of trimethoprim–sulfamethoxazole (a broad-spectrum antimicrobial agent with anti-inflammatory properties, widely used in sub-Saharan Africa) would result in heavier birth weights, decreased premature births, and better health outcomes for their babies.  

993 pregnant women were recruited from three antenatal clinics in Shurugwi, a district in central Zimbabwe, and received either 960 mg of the drug or a placebo daily. The participants received regular antenatal care during their pregnancies and data regarding their birth outcomes were recorded. 

The study, published in the New England Journal of Medicine, found that although birthweight did not differ significantly between the two groups, the trimethoprim–sulfamethoxazole group showed a 40% reduction in the proportion of preterm births, compared to the placebo group. Overall, 6.9% of mothers receiving the drug had babies born preterm, compared to 11.5% of mothers receiving the placebo, and no women receiving antibiotics had babies born prior to 28 weeks. For babies born to a small group of 131 women with HIV, the reduction in premature births was especially marked, with only 2% of births in the trimethoprim–sulfamethoxazole group preterm, as compared with 14% in the placebo group. Babies exposed to antibiotics during pregnancy also showed a 177 gram increase in their birth weight. 

Bernard Chasekwa, first author, said: “Our trial, conducted within routine antenatal care and enrolling women predominantly from rural areas, showed that trimethoprim-sulfamethoxazole did not improve birthweight, which was our main outcome. However, there was an intriguing suggestion that it may have improved the length of pregnancy and reduced the proportion of preterm births. We now need to repeat this trial in different settings around the world to see whether antibiotics during pregnancy can help reduce the risk of prematurity.”  

Source: Queen Mary University of London