Limiting Adverse Birth Outcomes in Resource-Limited Settings

This is a prospective multi-country cohort study of up to 15,000 women admitted to the hospital for delivery or for management of respiratory infection. Women will be recruited and screened for study participation at the time of presentation to the hospital. Participants will be assessed through hospitalization, labor, delivery, and discharge and at 1- and 6-week postpartum contacts. Liveborn infants will be enrolled at birth and followed through 42 days of life. The pilot phase of this protocol will enroll up to 500 women in labor and their newborns and follow them through labor, delivery, and 42 days postpartum.

Inclusion criteria

for women enrolled:

• Maternal age of majority
• Intrauterine singleton pregnancy
• Admission to the hospital for ANY of the following:

• vaginal delivery
• cesarean delivery in the presence of signs/symptoms of parturition, elevated blood pressure, or fever
• management of respiratory infection*
• Ability and willingness to provide written informed consent
• Willingness to adhere to study procedures
• Willingness to provide locator information for follow-up

• Inclusion of participants admitted to hospital for management of respiratory infection applicable to Zambia site only.

Exclusion criteria

for women enrolled:

• Admission to the hospital for cesarean delivery in the absence of signs/symptoms of parturition, elevated blood pressure, or fever
• Any condition (social or medical) that, in the opinion of study staff, would make participation unsafe or not feasible. Study staff may note physical, psychological, or social conditions that are not explicitly stated in the eligibility criteria that could make some women poor candidates for study participation.