Maternal antibiotics and decreased periventricular leukomalacia in very low-birth-weight infants.
OBJECTIVE
To investigate the effect of maternal antibiotics, given in the predelivery period, on neonatal outcomes.


METHODS
Retrospective cohort study.


METHODS
A single level 3 neonatal intensive care unit.


METHODS
All infants with birth weights 1500 g or less cared for from July 1994 to July 2000 (n = 834) were included in the study. Mothers were classified as receiving antibiotics if they received any parenteral antibiotics in the predelivery period. Infants whose mothers received antibiotics were compared with infants whose mothers received no antibiotics.


METHODS
The main outcome variables studied included intraventricular hemorrhage (IVH), cystic periventricular leukomalacia (PVL), sepsis, and mortality.


RESULTS
Of 834 mothers, 374 (45%) received antibiotics prior to delivery. On univariate analysis, there were no differences in the relative risk (RR) of mortality (1.26; 95% confidence interval [CI], 0.86-1.79) or grades 3 to 4 IVH (RR, 1.39; 95% CI, 0.82-1.90) between the antibiotics and no-antibiotics groups. Infants born to mothers receiving antibiotics had an increased risk of culture-proven sepsis (RR, 1.4; 95% CI, 1.02-1.64) and a decreased risk of cystic PVL (RR, 0.26; 95% CI, 0.09-0.79) compared with infants whose mothers did not receive antibiotics. After controlling for confounding variables, maternal antibiotics were not associated with a decrease in the risk of mortality (adjusted risk [AR], 1.0; 95% CI, 0.5-2.1), grades 3 to 4 IVH (AR, 1.0; 95% CI, 0.5-1.9), or sepsis (AR, 0.9; 95% CI, 0.7-1.4). However, the use of maternal antibiotics was associated with a decreased risk of developing cystic PVL (AR, 0.09; 95% CI, 0.02-0.5).


CONCLUSIONS
In our population of very low-birth-weight infants, maternal antibiotics were associated with a decreased risk of cystic PVL. Maternal antibiotics do not change the risk of mortality, sepsis, or severe IVH.
Paul
David A
DA
Section of Neonatology, Christiana Hospital, 4755 Ogletown-Stanton Rd, Newark, DE 19718, USA. paul.d@christianacare.org
Coleman
Mae M
MM
Leef
Kathleen H
KH
Tuttle
Deborah
D
Stefano
John L
JL
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D019102:Infant, Very Low Birth Weight; D007743:Labor, Obstetric; D007969:Leukomalacia, Periventricular / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012306:Risk; D018805:Sepsis / Q000453:epidemiology*; D016019:Survival Analysis
D000900:Anti-Bacterial Agents