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In LMICs, women who develop preterm labour often deliver at home or in inadequately resourced facilities. Working with professionals in South Africa, Bangladesh and India, we will develop PTB care guidance and training packages for frontline carers involved in managing PTB. We will also develop a kit comprising essential material for looking after a premature baby at home
In LMICs, health-promoting behaviours that may reduce PTB risk are not always supported, women often register late for prenatal care, pregnancy is often inaccurately dated, and the risk of PTB seldom assessed. We will investigate the possibility of screening pregnant women for PTB in LMICs by measuring 'metabolites' in vaginal fluids and investigating the feasibility of using a new device, developed in Sheffield as part of the ECCLIPPx™ study (funded by the MRC), to assess the cervix at 20 weeks of pregnancy, to predict or rule out subsequent premature births.
Infections that may contribute to the higher rates of PTB in LMICs have rarely been investigated. Understanding which of these infections cause PTB can enable them to be prevented and treated promptly during pregnancy. We therefore plan, for the first time, to study features of infection in the placentas of women who experience PTB to clarify which infections contribute to high rates of PTB in LMICs and how we can prevent, detect or treat them during pregnancy.