title: Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysis.
abstract: OBJECTIVE
  We conducted a metaanalysis to determine whether antibiotics prolong pregnancy and reduce neonatal morbidity in preterm premature rupture of membranes (PPROM) and preterm labor (PTL) at 34 weeks or less.
  
  
  METHODS
  Randomized trials comparing antibiotic therapy with placebo in PPROM or PTL at a gestation of 34 weeks or less were retrieved. The primary outcome was time to delivery (latency). Infant outcomes included mortality, infection, neurological abnormality, respiratory disease, and neonatal stay.
  
  
  RESULTS
  Antibiotics were associated with prolongation of pregnancy in PPROM (P < .01) but not PTL. Clinically diagnosed neonatal infections were reduced in both groups; there was a trend toward reduced culture-positive sepsis in PPROM. Intraventricular hemorrhage (all grades) was reduced in PPROM. Other neonatal outcomes were unaffected by antenatal antibiotics.
  
  
  CONCLUSIONS
  Antibiotics prolong pregnancy and reduce neonatal morbidity in women with PPROM at a gestation of 34 weeks or less. In PTL at a gestation of 34 weeks or less, there is little evidence of benefit from administration of antibiotics.
authors.affiliation: Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Hutzal
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Boyle
authors.forename: Sara L
authors.initials: SL
authors.lastname: Kenyon
authors.forename: Jennifer V
authors.initials: JV
authors.lastname: Nash
authors.forename: Stephanie
authors.initials: S
authors.lastname: Winsor
authors.forename: David J
authors.initials: DJ
authors.lastname: Taylor
authors.forename: Haresh
authors.initials: H
authors.lastname: Kirpalani
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy* / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D007752:Obstetric Labor, Premature / Q000188:drug therapy* / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011336:Probability; D016032:Randomized Controlled Trials as Topic; D012016:Reference Values; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents