Pregnancy is a critical time, and babies born too early, known as preterm, face a dire challenge – many don’t survive the neonatal period. In 2020, one in four babies globally was preterm, small, or of low birthweight, termed “small vulnerable newborns.” Their survival is particularly challenging in low- and middle-income countries. The long-term sequelae of vulnerable births also cast a shadow, impacting the quality of life, and causing economic losses in society.

Preventing preterm birth and fetal growth restriction poses a multifaceted challenge due to numerous contributing factors. Limited resources exacerbate the complexity of the task. However, it’s noteworthy that maternal nutrition and infections or inflammation collectively contribute to over half of small vulnerable newborn cases in severely affected settings. As a result, the AAA pregnancy study aims to accelerate research for low-cost interventions, focusing on nutrition, infection, and inflammation strategies to emphasize holistic prevention.

Building on evidence from large trials, AAA pregnancy will study the impact of daily antenatal micronutrients and low-dose aspirin on the occurrence of preterm birth and related outcomes. Azithromycin will be integrated into this combination intervention (AAA), as a comprehensive approach in pregnancy to enhance newborn health and potentially mitigate long-term effects from vulnerable births, ultimately contributing to improved societal well-being.