Despite the burden of maternal peripartum infections, the quality of the evidence backing the recommendations made in this guideline was generally rated low or very low. For evidence rated low or very low, the GRADE methodology suggests that further research is very likely to have an impact on the direction and/or strength of the recommendation. In contrast, for evidence rated high or moderate, new research is not a priority.

Based on this approach, the GDG identified critical gaps in current evidence regarding the prevention and treatment of infectious conditions around childbirth. These knowledge gaps were prioritized according to their potential to improve maternal and/or neonatal outcomes and quality of care, incremental value, feasibility and likelihood to address equities. It was also noted that evidence is lacking regarding some widely used practices, such as the use of prophylactic antibiotics to prevent infectious morbidities in women with episiotomy or women having normal low-risk labour. In no order of priority, the following were the research gaps identified during the guideline development process:

• What is the comparative effectiveness and safety of chlorhexidine and povidone-iodine for vaginal cleansing among women undergoing caesarean section in preventing maternal infection morbidities?

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  What are the effects of vaginal cleansing immediately before caesarean section among women at potentially higher risk of infection (e.g. women with ruptured membranes)?

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  Is there any difference in the incidence of maternal infection morbidities between vaginal cleansing performed before or immediately after caesarean section?

• What are the potential adverse effects of the use of iodine containing antiseptics for vaginal cleansing for the newborn if the mother is planning to breastfeed?
• What are women's views and preferences (including satisfaction) about perineal/pubic shaving prior to vaginal birth?
• What is the incidence of immediate and short-term complications (razor, vulval itching and burning sensation, discomfort during hair regrowth) after perineal/pubic shaving in postpartum?
• What are the effects of routine prophylactic antibiotics on perineal wound infection morbidity among women with episiotomy?
• What are the effects of routine prophylactic antibiotics on preventing infection morbidity among women with normal (uncomplicated) vaginal birth?
• What are the effects of routine prophylactic antibiotics during the second and third trimester on women carrying high-risk pregnancies (e.g. history of preterm birth, low birthweight, previous preterm birth with bacterial vaginosis in the current pregnancy)?
• What is the contribution of the duration of rupture of membranes and length of labour on maternal and neonatal infectious morbidity among women with PROM at term?
• What are the benefits of initiating prophylactic antibiotics after prolonged rupture of membranes at term?
• What is the effect of administration of antibiotics prior to initiation of caesarean section on antibiotic resistance patterns in the neonates and longer-term infant health?