Antibiotics and preterm birth
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
The risk of preterm labour in the presence of maternal infection is 30% to 50%. Antibiotics may induce a significant 12-20% reduction in neonatal infections following preterm rupture of the membranes and may prolong pregnancy significantly. Methods: Aiming to evaluate the effectiveness of using antibiotics at any time during pregnancy to prevent preterm birth, Cochrane Library, MEDLINE, BIOSIS, EMBase, and CINAHL was searched and no language restrictions was applied. Reviews and RCT’s assessing the use of antibiotics during pregnancy with outcome data on preterm labour and birth were selected. Results: more than forty randomised controlled trials published between 1966 and the present day were included. They showed mild decrease in the incidence of preterm birth before 37 weeks with the use of antibiotics. Added to that, an average 34% less maternal infective morbidity with the use of antibiotics compared to placebo or no treatment for all antibiotic groups, all indications, and all gestational ages. More than fifteen reviews published between 1993 and the present day were included, showing an average 30% decrease in the incidence of neonatal morbidity, 45% less maternal infective morbidity and an average 17% increase in the maternal adverse effects with the use of antibiotics compared to placebo or no treatment for all indications and all gestational ages. In both trials and reviews, there is a noticeable increase in preterm births with the use of Metronidazole compared to placebo or no treatment Conclusions: The result of this umbrella review does not support the use of antibiotics during pregnancy except when there is a clear evidence of infection with extreme caution, regular follow-ups and monitoring of the patient. In addition to, not supporting the use of metronidazole during pregnancy.
Authors and Affiliations
Dr Mohammad Othman
Keywords
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- EP ID EP592716
- DOI 10.9790/0853-160302135149
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