Effect of prenatal and perinatal antibiotics on maternal health in Malawi, Tanzania, and Zambia

Int J Gynaecol Obstet. 2009 Dec;107(3):202-7. doi: 10.1016/j.ijgo.2009.07.037. Epub 2009 Aug 28.


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.

Conclusion: Administration of study antibiotics during pregnancy had no effect on maternal morbidity and mortality among HIV-infected and uninfected pregnant women.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis*
  • Female
  • HIV Infections / epidemiology
  • Humans
  • Incidence
  • Malawi
  • Maternal Mortality
  • Maternal Welfare
  • Obstetric Labor Complications / epidemiology
  • Obstetric Labor Complications / prevention & control
  • Odds Ratio
  • Perinatal Care / methods*
  • Pregnancy
  • Prenatal Care / methods*
  • Puerperal Infection / epidemiology
  • Puerperal Infection / prevention & control*
  • Tanzania
  • Young Adult
  • Zambia


  • Anti-Bacterial Agents