Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysis
Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysis
复制标题
DOI：
10.1016/j.ajog.2008.07.008
复制
发表时间：
2008-01-01
影响因子：
9.8
通讯作者：
Kirpalani, Haresh
中科院分区：
文献类型：
--
作者：
Hutzal, Carolyn E.;Boyle, Elaine M.;Kirpalani, Haresh
目的：我们进行了一项荟萃分析，以确定是否抗生素延长妊娠和降低新生儿发病率在早产胎膜早破（PPROM）和早产（PTL）在34周或更少。研究设计：随机试验比较抗生素治疗与安慰剂在PPROM或PTL在妊娠34周或更少的检索。主要结局是分娩时间（潜伏期）。婴儿结局包括死亡率、感染、神经系统异常、呼吸系统疾病和新生儿住院时间。结果：抗生素与PPROM的妊娠延长有关（P <0.01），但与PTL无关。两组临床诊断的新生儿感染均减少; PPROM中培养阳性脓毒症有减少的趋势。脑室内出血（所有等级）在PPROM中减少。结论：抗生素可延长妊娠期，降低妊娠34周或以下PPROM妇女的新生儿发病率。对于妊娠34周或以下PTL，
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.STUDY DESIGN: 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.CONCLUSION: 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