Table 19

Research gaps

Basic science and physiological studies

• Mechanisms of causation of hypertensive disorders of pregnancy and how these cause stillbirths*

• Auto-immune pathophysiology in stillbirth causation

• Association of periodontal disease with pre-eclampsia and pathophysiology of subsequent stillbirth*

• Dynamics of stillbirth causation in intrahepatic cholestasis

• Drug safety and efficacy studies:

◦ Anti-malarials in pregnancy

◦ Drugs for intrahepatic cholestasis

◦ Non-penicillin treatments for syphilis

◦ Antibiotic use in pregnancy

• Identification of other unknown risk factors

• Prevalence of uterine abnormalities in low-/middle-income countries

Pilot/cohort studies of interventions

• New approaches for PIH and chronic hypertension management in community settings*

• Management protocols for HIV and syphilis co-infection

• Management of penicillin drug allergy in community settings

• Diagnosis and surgical repair of uterine abnormalities in women with recurrent fetal loss

• Intravenous immunoglobulin treatment (compared to heparin, aspirin, or other anti-coagulants) in selected populations with recurrent pregnancy loss and antiphospholipid antibodies

Well-designed large RCTs of interventions powered to detect stillbirths

• Periodontal care studies powered to detect impact on stillbirth rates*

• Calcium supplementation to prevent PIH and pre-eclampsia in deficient populations

• Anti-oxidant supplementation in deficient populations

• Management of intrahepatic cholestasis including nonstress test, amniotic fluid index, meconium screening and early delivery

• Calcium supplementation in high-risk pregnancies*

• Antibiotics for pPROM*

Effectiveness trials in large populations/at scale

• Maternal anti-helminthic treatment: impact on maternal anaemia and stillbirth*

• On-site syphilis testing and treatment

• ITNs for Plasmodium vivax and in lower-transmission settings (Asia and Latin America)

*Priority areas

Menezes et al. BMC Pregnancy and Childbirth 2009 9(Suppl 1):S4   doi:10.1186/1471-2393-9-S1-S4