Antibiotics for pre-term pre-labour rupture of membranes: prevention of neonatal deaths due to complications of pre-term birth and infection.
Antibiotics for pre-term pre-labour rupture of membranes: prevention of neonatal deaths due to complications of pre-term birth and infection.
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DOI：
10.1093/ije/dyq030
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发表时间：
2010-04
影响因子：
7.7
通讯作者：
Lawn JE
中科院分区：
文献类型：
--
作者：
Cousens S;Blencowe H;Gravett M;Lawn JE
背景在高收入国家，标准做法是给早产、产前胎膜破裂（pPROM）的妇女使用抗生素，以推迟分娩并降低感染风险。在低收入和中等收入环境中，每年约有200万新生儿死于早产或感染的并发症，许多妇女没有接受过胎膜早破的抗生素治疗。目的回顾低收入和中等收入国家对胎膜早破妇女使用抗生素对早产并发症或感染所致新生儿死亡率的影响。方法我们对科克伦综述进行了系统评价。使用标准化的抽象形式。使用适应性GRADE方法评估了单项研究和总体研究提供的证据质量。结果18个随机对照试验符合纳入标准。大多数来自高收入国家，并提供了强有力的证据表明抗生素治疗胎膜早破可降低呼吸窘迫综合征[风险比（RR）= 0.88;置信区间（CI）0.80，0.97]和早发性产后感染（RR = 0.61; CI 0.48，0.77）的风险。这些数据与新生儿死亡率降低一致（RR = 0.90; CI 0.72，1.12）。结论抗生素治疗胎膜早破可减少高收入环境中早产和产后感染的并发症。有中等质量的证据表明，在低收入环境中，其他干预措施（产前类固醇，表面活性剂治疗，通气，抗生素治疗）可能较低，抗生素治疗胎膜早破可以防止4%的新生儿因早产并发症死亡和8%的新生儿因感染死亡。
Background In high-income countries, it is standard practice to give antibiotics to women with pre-term, pre-labour rupture of membranes (pPROM) to delay birth and reduce the risk of infection. In low and middle-income settings, where some 2 million neonatal deaths occur annually due to complications of pre-term birth or infection, many women do not receive antibiotic therapy for pPROM. Objectives To review the evidence for and estimate the effect on neonatal mortality due to pre-term birth complications or infection, of administration of antibiotics to women with pPROM, in low and middle-income countries. Methods We performed a systematic review to update a Cochrane review. Standardized abstraction forms were used. The quality of the evidence provided by individual studies and overall was assessed using an adapted GRADE approach. Results Eighteen RCTs met our inclusion criteria. Most were from high-income countries and provide strong evidence that antibiotics for pPROM reduce the risk of respiratory distress syndrome [risk ratio (RR) = 0.88; confidence interval (CI) 0.80, 0.97], and early onset postnatal infection (RR = 0.61; CI 0.48, 0.77). The data are consistent with a reduction in neonatal mortality (RR = 0.90; CI 0.72, 1.12). Conclusion Antibiotics for pPROM reduce complications due to pre-term delivery and post-natal infection in high-income settings. There is moderate quality evidence that, in low-income settings, where access to other interventions (antenatal steroids, surfactant therapy, ventilation, antibiotic therapy) may be low, antibiotics for pPROM could prevent 4% of neonatal deaths due to complications of prematurity and 8% of those due to infection.
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影响因子：
168.9
作者：
Kenyon, SL;Taylor, DJ;Tarnow-Mordi, W
通讯作者：
Tarnow-Mordi, W
影响因子：
2.4
作者：
Fuhr, NA;Becker, C;Hopp, H
通讯作者：
Hopp, H
DOI：
10.1016/s0020-7292(99)00036-3
发表时间：
1999-06-01
影响因子：
3.8
作者：
Magwali, TL;Chipato, T;Mujaji, C
通讯作者：
Mujaji, C
DOI：
10.1038/sj.jp.7211270
发表时间：
2005-03-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Bang, Abhay T;Reddy, Hanimi M;Deshmukh, Mahesh D
通讯作者：
Deshmukh, Mahesh D
影响因子：
2
作者：
KURKI, T;HALLMAN, M;YLIKORKALA, O
通讯作者：
YLIKORKALA, O