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Prophylactic antibiotics for inhibiting preterm labour in women whose membranes are still intact

Flenady V, Hawley G, Stock OM, Kenyon S, Badawi N
Published Online: 
5 December 2013

We found no benefit for the use of antibiotics for women going into labour too early, with their membranes still intact.

Maternal infection in the cervix or uterus may trigger preterm labour even if the infection does not cause symptoms (low grade infection). Preterm babies can have a range of complications, which often require admission to a neonatal intensive care unit, for example, because of breathing problems. Complications of being born early may result in death or longer-term disability such as chronic lung disease or cerebral palsy. Our systematic review of randomised trials, which included a total of 14 studies randomising 7837 women in preterm labour at a mean gestational age of 30 to 32 weeks compared routine administration of antibiotics before membrane rupture with placebo or no treatment for women without signs of infection. While antibiotics reduced the number of women who developed infections, they did not improve outcomes for the infant in terms of birth before 36 to 37 weeks, perinatal deaths or admission to neonatal intensive care or special care with serious illness. The review also found that antibiotic therapy was associated with an increase in neonatal deaths, functional impairment and cerebral palsy at seven years of age. The results of this review supports not giving antibiotics to women in threatened preterm labour with intact membranes who did not have clear signs of infection.