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Table 19 Research gaps

From: Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy

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)
  1. *Priority areas