UAB/AKU Global Network Research Unit

我们将在伯明翰建立一个亚拉巴马大学-阿加汗大学多学科研究小组，其主要目标是减少巴基斯坦与感染有关的围产期死亡率。 为了实现这一目标，我们将继续围绕一系列关于围产期感染和妊娠结局的研究建立UAB-AKU研究关系。 第一项研究将描述两个巴基斯坦孕妇群体的特征。将进行一项由1500名城市妇女和随后的1500名农村妇女组成的队列研究，在该研究中，将收集接近妊娠中期的感染数据，如细菌性阴道病、淋病和衣原体感染，以及各种妊娠相关的宫颈阴道和血清感染标志物。这些数据将与妊娠结局相关。 我们还将收集心理、营养、医疗和牙科数据，并将这些结果与阴道细菌感染、感染标志物和妊娠结局相关联。 本研究的目的是：1）确定两个巴基斯坦人群的当前妊娠结局，2）确定这两个人群中阴道感染的患病率和感染标志物，3）确定与阴道感染相关的各种心理社会，营养，医疗和牙科因素的患病率，感染标志物和不良妊娠结局。 在完成城市队列研究后，将邀请因以前围产期死亡而被确定为围产期死亡高风险的妇女参加产前和围产期抗生素的随机试验，以降低与感染有关的围产期死亡率。 在这项研究中，以前有过死胎或新生儿死亡的妇女将在孕中期后期随机接受一周的甲硝唑和红霉素或安慰剂治疗，并在分娩时重复抗生素或安慰剂治疗。主要终点为围产期死亡率。 我们的第二个降低感染相关死亡率的尝试是在分娩期和婴儿期洗必泰冲洗与安慰剂盐水冲洗的随机试验中。 随着这些项目的完成，我们不仅将回答与感染和妊娠结局相关的一些非常重要的问题，而且AKU与UAB合作，将开发与其发展中的孕产妇保健系统紧密相关的一流的农村和城市妊娠相关研究基础设施。

We will develop a University of Alabama at Birmingham-Aga Khan University multidisciplinary research team with its major goal the reduction of infection-related perinatal mortality in Pakistan. To accomplish this goal, we will continue to build the UAB-AKU research relationship around a series of studies on perinatal infection and pregnancy outcome. The first study will characterize two populations of Pakistani pregnant women. A cohort study consisting of 1500 urban and later 1500 rural women will be performed in which data will be collected near mid-pregnancy on infections such as bacterial vaginosis, gonorrhea and chlamydia, and on various pregnancy-associated cervicovaginal and serum markers of infections. These data will be correlated with pregnancy outcome. We will also collect psychosocial, nutritional, medical and dental data and correlate these results with bacterial infection of the vagina, the infection markers and with pregnancy outcome. The goal of this study is 1) to determine the current pregnancy outcomes in two Pakistani populations, 2) to determine the prevalence of vaginal infections and markers of infection in these two populations, and 3) to determine the prevalence of various psychosocial, nutritional, medical and dental factors associated with vaginal infection, markers of infection and adverse pregnancy outcomes. Upon completion of the urban cohort study, women identified as high risk for perinatal death because of a previous perinatal death will be invited to participate in a randomized trial of prenatal and perinatal antibiotics to reduce infection-related perinatal mortality. In this study, women who have had a previous stillbirth or a neonatal death will be randomized to one week of treatment with metronidazole and erythromycin or placebos in the late second trimester, with a repeat course of antibiotics or placebo in labor. The primary endpoint will be perinatal mortality. Our second attempt to decrease infection-related mortality will be in a randomized trial of an intrapartum and infant chlorhexidine wash versus placebo washes with saline. With the completion of these projects, not only will we have answered some very important questions related to infections and pregnancy outcome, but AKU, in partnership with UAB, will have developed superb rural and urban pregnancy-related research infrastructures tightly linked to their developing maternity health care systems.