New Delhi: A commonly used and low-cost antibiotic, trimethoprim–sulfamethoxazole, may help reduce the risk of preterm birth among pregnant women with HIV, according to a study involving nearly 1,000 women in Zimbabwe.
Researchers from the UK and Zimbabwe conducted a randomized controlled trial involving 993 pregnant women from three antenatal clinics in central Zimbabwe. Participants received either a daily dose of 960 mg of trimethoprim–sulfamethoxazole or a placebo.
The study found that among a subgroup of 131 women with HIV, 2% of those who took the antibiotic had preterm births, compared to 14% 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.
Trimethoprim–sulfamethoxazole is a broad-spectrum antimicrobial with anti-inflammatory effects and is widely used in sub-Saharan Africa.
Across the full study population, the overall rate of preterm birth was 6.9% in the group receiving the antibiotic, compared to 11.5% in the placebo group.
The study also reported that no women in the antibiotic group delivered before 28 weeks of gestation. However, average birth weight did not differ significantly between the two groups.
Preterm birth, low birth weight, and small size for gestational age affect about one in four live births globally. Prematurity is now the leading cause of death among children under five. Infections and inflammation during pregnancy are linked to these outcomes, especially in women living with HIV.
The findings were published in the New England Journal of Medicine. Researchers note that additional studies are needed to confirm the results before recommending changes to current clinical practice.