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Table 13 Impact of antibiotics for PPROM/PROM on stillbirth and perinatal outcomes

From: Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy

Source Location and Type of Study Intervention Stillbirths/Perinatal Outcomes
Reviews and meta-analyses
Flenady and King 2002 [151] . Spain. Meta-analysis (Cochrane). 2 RCTs included (N = 838 women). Compared the impact of any antibiotic (intervention) vs. no antibiotic (controls) in cases of PROM ≥ 36 wks' gestation. PMR: RR = 0.98 (95% CI: 0.14 – 6.89) [NS] [2/426 vs. 2/412 in intervention vs. control groups, respectively].
Kenyon et al. 2003 [150] Mozambique, Norway, Sweden, USA, Spain, UK, Finland, Chile, Denmark. Meta-analysis (Cochrane). 19 RCTs included (N = 6411). Compared the impact of any antibiotic (intervention) vs. placebo (controls) in cases of PPROM. PMR/death before hospital discharge: RR = 0.90 (95% CI: 0.74–1.10) [NS] [data from 13 RCTs]. [281/4374 vs. 148/2037 in intervention vs. control groups, respectively].
Intervention studies
Kenyon et al. 2002 [201] UK and other international sites. Multicentre. RCT. Pregnant women (N = 4826) with PPROM. Assessed the effects of co-amoxiclav and erythromycin singly and in combination: 325 mg co-amoxiclav plus 250 mg erythromycin (group 1), co-amoxiclav plus erythromycin placebo (group 2), erythromycin plus co-amoxiclav placebo (group 3), or co-amoxiclav placebo plus erythromycin placebo (group 4). Antibiotics given 4× daily for 10 d or until delivery. NMR: 5.2% vs. 5.7% vs. 6.2% in erythromycin (group 3), co-amoxiclav (group 2) and placebo (group 4), respectively. Major neonatal cerebral abnormality lower with erythromycin vs. placebo or co-amoxiclav.