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Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysis

2008; Elsevier BV; Volume: 199; Issue: 6 Linguagem: Inglês

10.1016/j.ajog.2008.07.008

1097-6868

Carolyn E. Hutzal, Elaine M. Boyle, Sara Kenyon, Jennifer Nash, Stephanie Winsor, David J. Taylor, Haresh Kirpalani,

Infant Development and Preterm Care

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.