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Prophylactic antibiotic administration in pregnancy to prevent infectious morbidity and mortalityThinkhamrop J, Hofmeyr GJ, Adetoro O, Lumbiganon P
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SummaryProphylactic antibiotic administration in pregnancy to prevent infectious morbidity and mortalityRoutine antibiotic treatment in second and third trimester of pregnancy can reduce some infectious morbidity on pregnancy outcomes. Maternal genital tract infection or colonization by some infectious organisms can cause maternal and perinatal mortality and morbidity. Antibiotics have been used during the second and third trimester to try to prevent these infections. The review of trials found that antibiotics reduce the risk of prelabour rupture of membranes in unselected pregnant women and low birth weight and postpartum endometritis in high-risk pregnant women. Further study to identify the most appropriate type and dosage of routine use antibiotics in pregnant women should be conducted.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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October 21. 2002 AbstractBackgroundSome previous studies have suggested that prophylactic antibiotics given during pregnancy improved maternal and perinatal outcomes, some have shown no benefit and some have reported adverse effects. ObjectivesTo determine the effect of prophylactic antibiotics during second and third trimester of pregnancy on maternal and perinatal outcomes. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group trials register (January 2004) and reference lists of articles. Selection criteriaRandomized controlled trials comparing prophylactic antibiotic treatment with placebo or no treatment for women in the second or third trimester of pregnancy before labour. Data collection and analysisWe assessed trial quality extracted data. Main resultsThe review included six randomized controlled trials which recruited 2184 women to detect the effect of prophylactic antibiotic administration on pregnancy outcomes in the second or third trimester. Antibiotic prophylaxis in unselected pregnant women reduced the risk of prelabour rupture of membranes (Peto odds ratio (OR) 0.32, 95% confidence interval (CI) 0.14 to 0.73). In women with a previous preterm birth there was a risk reduction in low birth weight (OR 0.48, 95% CI 0.27 to 0.84) and postpartum endometritis (OR 0.46, 95% CI 0.24 to 0.89). There was a risk reduction in preterm delivery (OR 0.48, 95% CI 0.28 to 0.81) in pregnant women with a previous preterm birth associated with bacterial vaginosis (BV) during the current pregnancy but there was no risk reduction in pregnant women with previous preterm birth without BV during pregnancy (OR 1.06, 95% CI 0.68 to 1.64). However, vaginal antibiotic prophylaxis during pregnancy did not prevent infectious pregnancy outcomes and there is a possibility of adverse effects such as neonatal sepsis (OR 8.07, 95% CI 1.36 to 47.77). Authors' conclusionsAntibiotic prophylaxis given during the second or third trimester of pregnancy reduces the risk of prelabour rupture of membranes when given routinely to pregnant women. Beneficial effects on birth weight and the risk of postpartum endometritis were seen for high-risk women. |