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A groundbreaking clinical trial led by a University of Oklahoma physician-researcher aims to reduce the high rates of cesarean sections (C-sections) among pregnant women with obesity. Dr. Stephanie Pierce, a maternal-fetal medicine specialist, has been awarded a $3.1 million grant from the National Institutes of Health (NIH) to spearhead a multicenter national study that could potentially lower C-section rates for this high-risk group.
Obesity in pregnancy is a growing concern in the United States, with nearly 40% of pregnant women experiencing obesity. Obesity increases the likelihood of complications during pregnancy, including the need for early labor inductions and C-sections. C-sections, while life-saving in many cases, carry significant risks for mothers, such as wound infections, increased bleeding, and longer recovery times.
Dr. Pierce’s study, which is believed to be the first large-scale of its kind in the U.S., will explore the potential benefits of administering antibiotics at the start of labor induction. Her pilot study, published in the American Journal of Obstetrics and Gynecology, showed a promising 27% reduction in C-section deliveries among first-time mothers with obesity who received antibiotics during labor induction.
The theory behind the use of antibiotics is based on their ability to reduce inflammation in the body. Obesity is known to cause chronic low-level inflammation, which may interfere with the normal functioning of the uterine muscles during labor. Labor itself is also an inflammatory process, and excessive inflammation may cause problems that lead to the need for a C-section. Antibiotics, such as azithromycin or cefazolin, could potentially treat underlying infections that are not showing visible symptoms but are still affecting the labor process.
In the clinical trial, nearly 800 pregnant women with obesity will be enrolled. Half of the participants will receive an intravenous dose of antibiotics, while the other half will receive a placebo. The study will track the participants’ health outcomes, including C-section rates, infection rates, and complications for both the mother and baby. The research team will also analyze blood and stool samples from both the mother and baby to investigate any changes in the microbiome, the collection of microbes that play a vital role in overall health.
This study will involve multiple institutions, including Duke University, the University of Alabama at Birmingham, the University of Florida, and MetroHealth Medical Center in Cleveland. Over the course of five years, the trial will gather data on the potential benefits of antibiotic prophylaxis in preventing obesity-related pregnancy complications, with the ultimate goal of improving maternal and fetal health.
Dr. Pierce expressed her excitement about the study’s potential, saying, “This is an exciting opportunity to develop a new intervention that can improve outcomes for pregnant women with obesity. The issue of obesity has been challenging to obstetricians, and the average BMI during pregnancy is only increasing. It is very gratifying to be part of a team that is developing a solution that has the potential to decrease complications and improve the health of mother and baby alike.”
This study represents a significant step forward in tackling the growing challenge of obesity during pregnancy, with the promise of improving health outcomes for both mothers and their newborns.
