OBJECTIVE: We conducted a metaanalysis to determine whether antibiotics prolong pregnancy and reduce neonatal morbidity in preterm premature rupture of membranes (PPROM) and preterm labor (PTL) at 34 weeks or less. STUDY DESIGN: Randomized trials comparing antibiotic therapy with placebo in PPROM or PTL at a gestation of 34 weeks or less were retrieved. The primary outcome was time to delivery (latency). Infant outcomes included mortality, infection, neurological abnormality, respiratory disease, and neonatal stay. RESULTS:Antibiotics were associated with prolongation of pregnancy in PPROM (P < .01) but not PTL. Clinically diagnosed neonatal infections were reduced in both groups; there was a trend toward reduced culture-positive sepsis in PPROM. Intraventricular hemorrhage (all grades) was reduced in PPROM. Other neonatal outcomes were unaffected by antenatal antibiotics. CONCLUSION:Antibiotics prolong pregnancy and reduce neonatal morbidity in women with PPROM at a gestation of 34 weeks or less. In PTL at a gestation of 34 weeks or less, there is little evidence of benefit from administration of antibiotics.
RCT Entities:
OBJECTIVE: We conducted a metaanalysis to determine whether antibiotics prolong pregnancy and reduce neonatal morbidity in preterm premature rupture of membranes (PPROM) and preterm labor (PTL) at 34 weeks or less. STUDY DESIGN: Randomized trials comparing antibiotic therapy with placebo in PPROM or PTL at a gestation of 34 weeks or less were retrieved. The primary outcome was time to delivery (latency). Infant outcomes included mortality, infection, neurological abnormality, respiratory disease, and neonatal stay. RESULTS: Antibiotics were associated with prolongation of pregnancy in PPROM (P < .01) but not PTL. Clinically diagnosed neonatal infections were reduced in both groups; there was a trend toward reduced culture-positive sepsis in PPROM. Intraventricular hemorrhage (all grades) was reduced in PPROM. Other neonatal outcomes were unaffected by antenatal antibiotics. CONCLUSION: Antibiotics prolong pregnancy and reduce neonatal morbidity in women with PPROM at a gestation of 34 weeks or less. In PTL at a gestation of 34 weeks or less, there is little evidence of benefit from administration of antibiotics.
Authors: Ronald F Lamont; Chia-Ling Nhan-Chang; Jack D Sobel; Kimberly Workowski; Agustin Conde-Agudelo; Roberto Romero Journal: Am J Obstet Gynecol Date: 2011-04-02 Impact factor: 8.661
Authors: Daniel B DiGiulio; Roberto Romero; Juan Pedro Kusanovic; Ricardo Gómez; Chong Jai Kim; Kimberley S Seok; Francesca Gotsch; Shali Mazaki-Tovi; Edi Vaisbuch; Katherine Sanders; Elisabeth M Bik; Tinnakorn Chaiworapongsa; Enrique Oyarzún; David A Relman Journal: Am J Reprod Immunol Date: 2010-03-21 Impact factor: 3.886
Authors: Hannah E Jones; Kathryn A Harris; Malika Azizia; Lindsay Bank; Bernadette Carpenter; John C Hartley; Nigel Klein; Donald Peebles Journal: PLoS One Date: 2009-12-08 Impact factor: 3.240