Status: Funded - Open
Intermittent treatment in pregnancy with azithromycin – does it prevent preterm birth by ablating inflammation?
Holger Unger, MBChB, M.Sc.
BACKGROUND: Inflammation and infection are associated preterm birth. Intermittent treatment in pregnancy with sulphadoxine-pyrimethamine and azithromycin, a macrolide antibiotic with favorable anti-malarial and anti-inflammatory properties, reduced preterm birth and low birthweight in two large clinical trials in Malawi and Papua New Guinea.
GAP: To date it remains unclear how azithromycin-based intermittent treatment reduced preterm birth and low birthweight, and whether this is at least in part achieved through the anti-inflammatory and anti-bacterial properties of the macrolide drug.
HYPOTHESIS: In Papua New Guinean women azithromycin-based intermittent treatment in pregnancy reduced preterm birth and low birthweight by resolving inflammation. Maternal biomarkers can be identified, levels of which correlate with risk of preterm birth.
METHODS: A secondary exploratory analysis of data and archived samples from a clinical trial of azithromycin-based intermittent treatment in pregnancy in Papua New Guinea will be conducted. Using blood plasma collected at antenatal booking and at delivery, inflammatory and angiogenic biomarkers (e.g. C-reactive protein and placental growth factor) will be measured. Statistical analyses will evaluate the relationship between these biomarkers and preterm birth, and whether possible associations are altered as a result of azithromycin therapy in pregnancy.
IMPACT: If successful the findings of the project are likely to lead to further studies of AZ use in pregnancy including trials of AZ-based combination therapies, and their possible implementation in low-income countries within the next 5-8 years. Identification of biomarkers associated with risk of preterm birth may lead to point-of-care tests to identify women at risk.
Website Link: http://www.researchgate.net/profile/Holger_Unger2
University of Melbourne