Introduction: Pregnant women and their offspring are often at increased direct and indirect risks of adverse outcomes during epidemics and pandemics. A coordinated research response is paramount to ensure that this group is offered at least the same level of disease prevention, diagnosis, and care as the general population. We conducted a landscape analysis and held expert consultations to identify research efforts relevant to pregnant women affected by disease outbreaks, highlight gaps and challenges, and propose solutions to addressing them in a coordinated manner.
Methods: Literature searches were conducted from 1 January 2015 to 22 March 2022 using Web of Science, Google Scholar and PubMed augmented by key informant interviews. Findings were reviewed and Quid analysis was performed to identify clusters and connectors across research networks followed by two expert consultations. These formed the basis for the development of an operational framework for maternal and perinatal research during epidemics.
Results: Ninety-four relevant research efforts were identified. Although well suited to generating epidemiological data, the entire infrastructure to support a robust research response remains insufficient, particularly for use of medical products in pregnancy. Limitations in global governance, coordination, funding and data-gathering systems have slowed down research responses.
Conclusion: Leveraging current research efforts while engaging multinational and regional networks may be the most effective way to scale up maternal and perinatal research preparedness and response. The findings of this landscape analysis and proposed operational framework will pave the way for developing a roadmap to guide coordination efforts, facilitate collaboration and ultimately promote rapid access to countermeasures and clinical care for pregnant women and their offspring in future epidemics.
Competing Interests: Competing interests: BK is a former member of Scientific Advisory Board of Pfizer and a current member of Data Safety Monitoring Board at J&J. Her employer received a grant from Pfizer. MK is a recipient of grants awarded to the institution by the National Institute for Health Research Healthcare Quality Improvement Programme. FMR is a member of Moderna’s Vaccine Safety Monitoring Board and Pfizer’s and Meissa’s Data Safety Monitoring Board (RSV vaccines) and Dynavax (plague vaccines). She has received grants awarded to her institution from NIH & CDC for COVID-19 vaccines and respiratory viruses epidemiology, Pfizer for COVID-19 vaccines and Gilead for remdesivir. Aside from being compensated for conducting reviews, FMR receives author royalties and consulting fees from Sanofi, Astra Zeneca, Merck and Moderna related to the prevention of viral respiratory infections. AS has received grants from USAID and BMGF which were awarded to his institution. He is a non-compensated member of Data Safety Monitoring Board/Advisory Board of IMPROVE (malaria chemoprevention) Trials and INTREPiD (malaria testing). AS also sits on Safety Platform for Emergency Vaccines (SPEAC) Executive Board and the Scientific Advisory Board of Vivli AMR Register in addition to receiving consulting fees from CEPI and PATH. CT receives support from Harvard School of Public Health, Yale School of Public Health, and the Pan American Health Organization. All other authors declare no competing interests. The collaboration between The Human Reproduction Programme (HRP), Department of Sexual and Reproductive Health, WHO and Research and Bill & Melinda Gates Foundation is governed by a bilateral agreement.
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