title: A secondary analysis of the WHO Global Survey on Maternal and Perinatal Health for antibiotics used in vaginal deliveries.
abstract: OBJECTIVE
  To assess the rate of antibiotic administration following vaginal delivery and to determine whether maternal characteristics and healthcare system features affected antibiotic use during or immediately after delivery using data from the WHO Global Survey on Maternal and Perinatal Health in Latin America, Africa, and Asia.
  
  
  METHODS
  The study included women who delivered vaginally without any obvious infection, diabetes, HIV, cardiorenal or respiratory disease, urinary tract infection, or rupture of membranes. The proportion of women receiving antibiotics within and across regions was determined and associated factors of prophylactic use were analyzed using generalized linear mixed models.
  
  
  RESULTS
  Of the 171,676 women giving birth vaginally, 47.3% received antibiotics, with half of these women receiving antibiotics during and/or immediately after delivery for prophylaxis. Among 131,554 women given prophylactic or no antibiotics, 31.2% received prophylactic antibiotics but the rate varied among regions. Women with an operative vaginal delivery (compared with those who delivered spontaneously) and women with third- or fourth-degree laceration were more likely to receive prophylactic antibiotics.
  
  
  CONCLUSIONS
  Antibiotic use following vaginal delivery varies widely across geographic regions; however, approximately one-third of women undergoing vaginal delivery without documented indication for antibiotic administration appear to have received antibiotics.
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand. Electronic address: ltippawa@yahoo.com.
authors.forename: Tippawan
authors.initials: T
authors.lastname: Liabsuetrakul
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Pisake
authors.initials: P
authors.lastname: Lumbiganon
authors.affiliation: Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mori
authors.affiliation: UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
authors.forename: Metin
authors.initials: M
authors.lastname: Gülmezoglu
authors.affiliation: UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Souza
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D011247:Pregnancy; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Operative vaginal delivery; Vaginal delivery