{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:58:45Z","timestamp":1792177125195,"version":"4.4.0"},"reference-count":30,"publisher":"Massachusetts Medical Society","issue":"17","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.nejmgroup.org\/legal\/terms-of-use.htm"}],"funder":[{"DOI":"10.13039\/100004440","name":"UKRI GCRF collective fund","doi-asserted-by":"publisher","award":["MRV005782\/1"],"award-info":[{"award-number":["MRV005782\/1"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["N Engl J Med"],"published-print":{"date-parts":[[2026,4,30]]},"DOI":"10.1056\/nejmoa2512698","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T22:00:14Z","timestamp":1763589614000},"page":"1685-1695","source":"Crossref","is-referenced-by-count":9,"title":["A Multicomponent Intervention to Improve Maternal Infection Outcomes"],"prefix":"10.1056","volume":"394","author":[{"given":"David","family":"Lissauer","sequence":"first","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"},{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Gadama","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona","family":"Waitt","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"},{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0878-4244","authenticated-orcid":false,"given":"Sonia","family":"Whyte","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girvan","family":"Burnside","sequence":"additional","affiliation":[{"name":"Institute of Population Health, University of Liverpool, Liverpool, United Kingdom"},{"name":"Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiswarya","family":"Anilkumar","sequence":"additional","affiliation":[{"name":"Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Makuluni","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peace","family":"Okwaro","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Yang","sequence":"additional","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Waitt","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"},{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"},{"name":"Wirral University Teaching Hospital NHS Foundation Trust, Upton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Musopole","sequence":"additional","affiliation":[{"name":"Malawi Ministry of Health, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Bilesi","sequence":"additional","affiliation":[{"name":"Malawi Ministry of Health, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertha","family":"Maseko","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Lwasa","sequence":"additional","affiliation":[{"name":"Kawempe National Referral Hospital, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Mugahi","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Olaro","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Lamorde","sequence":"additional","affiliation":[{"name":"Resolve to Save Lives, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirriam","family":"Makuta","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chimwemwe","family":"Kachiwaya","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tionge","family":"Mkandawire","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Malunga","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyadani","family":"Chitsulo","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Abitimo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabitha","family":"Ayabo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Weeks","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Hemming","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Gallos","sequence":"additional","affiliation":[{"name":"UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Program of Research, Development, and Research Training in Human Reproduction (Human Reproduction Program), Department of Sexual, Reproductive, Maternal, Child, Adolescent Health, and Ageing, World Health Organization, Geneva"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9546-9650","authenticated-orcid":false,"given":"Edward J. M.","family":"Monk","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Riches","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikondi","family":"Chapuma","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Nanyondo S.","sequence":"additional","affiliation":[{"name":"Palladium, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Lorencatto","sequence":"additional","affiliation":[{"name":"Centre for Behaviour Change, University College London, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Monahan","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Allegranzi","sequence":"additional","affiliation":[{"name":"World Health Organization, Eastern Mediterranean Regional Office, Cairo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Dunlop","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lou","family":"Atkins","sequence":"additional","affiliation":[{"name":"Centre for Behaviour Change, University College London, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Rosala-Hallas","sequence":"additional","affiliation":[{"name":"Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrol","family":"Gamble","sequence":"additional","affiliation":[{"name":"Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Address","family":"Malata","sequence":"additional","affiliation":[{"name":"Malawi University of Science and Technology, Limbe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Desmond","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Kommwa","sequence":"additional","affiliation":[{"name":"Partners in Health\u2013Sierra Leone, Freetown"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abi","family":"Merriel","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Parry-Smith","sequence":"additional","affiliation":[{"name":"Keele University, School of Medicine, Keele, United Kingdom"},{"name":"Telford Hospitals NHS Trust, Princess Royal Hospital, Apley Castle, Telford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Smith","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy","family":"Ndumu","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"Faque","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gertrude","family":"Banda","sequence":"additional","affiliation":[{"name":"Malawi Liverpool Wellcome Research Program, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alinane L.","family":"Nyondo-Mipando","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelline","family":"Twimukye","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Chater","sequence":"additional","affiliation":[{"name":"Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristotelis","family":"Diplas","sequence":"additional","affiliation":[{"name":"Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Brizuela","sequence":"additional","affiliation":[{"name":"UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Program of Research, Development, and Research Training in Human Reproduction (Human Reproduction Program), Department of Sexual, Reproductive, Maternal, Child, Adolescent Health, and Ageing, World Health Organization, Geneva"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao Paulo","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, Brazil"},{"name":"Pan American Health Organization, Americas Regional Office, World Health Organization, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Rylance","sequence":"additional","affiliation":[{"name":"World Health Emergencies Program, World Health Organization, Geneva"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0967-7320","authenticated-orcid":false,"given":"James","family":"Cheshire","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Hawker","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women\u2019s Hospital, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3261-9807","authenticated-orcid":false,"given":"Arri","family":"Coomarasamy","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women\u2019s and Reproductive Health, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Bonet","sequence":"additional","affiliation":[{"name":"UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Program of Research, Development, and Research Training in Human Reproduction (Human Reproduction Program), Department of Sexual, Reproductive, Maternal, Child, Adolescent Health, and Ageing, World Health Organization, Geneva"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"150","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00560-6"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30109-1"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002984"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-007077"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2021-321865"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12633"},{"key":"e_1_3_4_10_2","unstructured":"Statement on maternal sepsis. Geneva: World Health Organization 2017 (https:\/\/www.who.int\/publications\/i\/item\/WHO-RHR-17.02)."},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30020-7"},{"key":"e_1_3_4_12_2","unstructured":"2030 Global agenda for sepsis. Berlin: Global Sepsis Alliance 2024 (https:\/\/static1.squarespace.com\/static\/58a7025b8419c215b30b2df3\/t\/67d1879b8dbfb06f8c3be697\/1741784989573\/2030_Global_Agenda_for_Sepsis_Online.pdf)."},{"key":"e_1_3_4_13_2","unstructured":"World Health Assembly. Improving the prevention diagnosis and clinical management of sepsis. Geneva: World Health Organization 2017 (https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA70\/A70_R7-en.pdf)."},{"key":"e_1_3_4_14_2","unstructured":"World Health Assembly. Accelerate progress towards reducing maternal newborn and child mortality in order to achieve Sustainable Development Goal targets 3.1 and 3.2. Geneva: World Health Organization 2024 (https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA77\/A77_ACONF5-en.pdf)."},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05925-9"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200281"},{"key":"e_1_3_4_17_2","unstructured":"Cebekhulu S Cornelissen L Pattinson R. Too little too late: the recurrent theme in maternal deaths due to sepsis. Obstet Gynaecol Forum 2018;28:9-12 (https:\/\/hdl.handle.net\/10520\/EJC-11ea4f673a)."},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00248-5"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12350"},{"key":"e_1_3_4_20_2","unstructured":"WHO guidelines on hand hygiene in health care. Geneva: World Health Organization 2009 (https:\/\/iris.who.int\/handle\/10665\/44102)."},{"key":"e_1_3_4_21_2","unstructured":"WHO recommendations for the prevention and treatment of maternal peripartum infections. Geneva: World Health Organization 2015 (https:\/\/iris.who.int\/handle\/10665\/186171)."},{"key":"e_1_3_4_22_2","unstructured":"Abortion care guideline. 2nd ed. Geneva: World Health Organization 2024 (https:\/\/iris.who.int\/handle\/10665\/382157)."},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2303966"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06506-y"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.18009"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16658"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16005"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-083132"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212111"},{"key":"e_1_3_4_31_2","volume-title":"WHO recommendation on antibiotic prophylaxis during labour for vaginal birth","year":"2025","unstructured":"WHO recommendation on antibiotic prophylaxis during labour for vaginal birth. Geneva: World Health Organization, 2025 (https:\/\/www.who.int\/publications\/i\/item\/9789240115750)."}],"container-title":["New England Journal of Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJMoa2512698","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:57:41Z","timestamp":1788188261000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.nejm.org\/doi\/10.1056\/NEJMoa2512698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":30,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2026,4,30]]}},"alternative-id":["10.1056\/NEJMoa2512698"],"URL":"https:\/\/doi.org\/10.1056\/nejmoa2512698","relation":{},"ISSN":["0028-4793","1533-4406"],"issn-type":[{"value":"0028-4793","type":"print"},{"value":"1533-4406","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}