Prophylactic antibiotics for inhibiting preterm labour with intact membranes

King, Jim; Flenady, Vicki

doi:10.1002/14651858.cd000246

Cited by 149 publications

(103 citation statements)

References 29 publications

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“…Table 18 illustrates the 2 studies of antibiotic therapy for preterm labor in developing-country settings. 356,369 The overall conclusions from these studies were consistent with the results of the Cochrane meta-analysis 367 and the ORACLE II study. 368 conclusions Antibiotics for PPROM background.…”

Section: Antibiotics For Preterm Laborsupporting

confidence: 78%

“…[363][364][365] Pathogens were identified from the amniotic fluid in 10% to 15% of cases presenting with preterm labor. 366 A meta-analysis by the Cochrane collaboration of available RCTs of antibiotic therapy in preterm labor with intact membranes 367 identified that antibiotic treatment in this situation prolonged pregnancy (weighted mean difference: 5.4 days; CI: 0.9 -9.8 days). There was no effect on reduction of preterm births or on respiratory distress syndrome or neonatal sepsis, but a significant reduction in neonatal necrotizing enterocolitis (OR: 0.33; CI: 0.13-0.88) was noted.…”

Section: Antibiotics For Preterm Labormentioning

confidence: 99%

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Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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Section: Antibiotics For Preterm Laborsupporting

confidence: 78%

Section: Antibiotics For Preterm Labormentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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“…For women with premature rupture of the membranes, a meta-analysis of 22 studies with a total of 6800 women demonstrated the benefit of antibiotics both for lowering the frequency of chorioamnionitis (OR 0.66, 95% CI 0.46-0.96) and for preventing preterm birth within 48 hours (OR 0.71, 95% CI 0.58-0.87) or seven days (OR 0.79, 95% CI 0.71-0.89) (35). When antibiotics are given for preterm labor without premature rupture of the membranes, the rate of maternal infection is lower (OR 0.74, 95% CI 0.64-0.87), but pregnancy is not prolonged, nor is there any reduction of the rate of neonatal complications (36). For these reasons, the routine administration of antibiotics in premature labor is currently not recommended (37).…”

Section: Antibiotic Treatmentmentioning

confidence: 99%

The Prevention, Diagnosis and Treatment of Premature Labor

Schleußner¹

2013

Deutsches Ärzteblatt International

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“…Unfortunately treatment options remain very limited, especially in preterm newborns. Therapeutic limitations are mainly due to: (i) the lack of non-invasive and reliable diagnostic markers enabling the detection of placental and fetal insults prenatally, and (ii) uncertainties about drug metabolism and benefit/risk balance of drug administration, to both the pregnant mother and fetus (Kenyon et al, 2008;King et al, 2002;Perlman, 2006;Tegethoff et al, 2009). In contrast, postnatal treatment is a more clinically attractive option since diagnosis of prenatal inflammation and HI are most often made postnatally due to clinical investigations routinely performed in human neonates.…”

Section: Introductionmentioning

confidence: 99%

Postnatal administration of IL-1Ra exerts neuroprotective effects following perinatal inflammation and/or hypoxic-ischemic injuries

Girard¹,

Sébire²,

Brochu³

et al. 2012

Brain, Behavior, and Immunity

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New therapeutic strategies are needed to protect neonates, especially premature newborns, against brain injury and associated neurobehavioral deficits. The role of pro-inflammatory cytokines, especially IL-1β, in the pathophysiological pathway leading to neonatal brain damage is increasingly recognized and represents an attractive therapeutic target. We investigated the therapeutic potential of postnatal systemic administration of the interleukin (IL)-1 receptor antagonist (IL-1Ra) in an animal model of perinatal brain injury using the insults most common to human neonates, i.e. prenatal exposure to inflammation and/or postnatal hypoxia-ischaemia (HI). We found that postnatal administration of IL-1Ra preserved motor function and exploratory behavior after either prenatal exposure to inflammatory agent lipopolysaccharide (LPS) or postnatal HI insult. The deleterious effect of combined prenatal LPS and postnatal HI on brain development was also alleviated by administration of IL-1Ra, as seen by the protected neural stem cell population, prevention of myelin loss in the internal capsule, decreased gliosis, and decreased neurobehavioral impairment. This study showed the distinct pattern of functional deficits induced by prenatal inflammation as compared to postnatal HI and the therapeutic potential of IL-1Ra administration against neonatal brain injury. Furthermore, our results highlight the potential for postnatal treatment of prenatal inflammatory stressors.

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Prophylactic antibiotics for inhibiting preterm labour with intact membranes

Cited by 149 publications

References 29 publications

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

The Prevention, Diagnosis and Treatment of Premature Labor

Postnatal administration of IL-1Ra exerts neuroprotective effects following perinatal inflammation and/or hypoxic-ischemic injuries

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