Prophylactic antibiotics for inhibiting preterm labour with intact membranes

Prophylactic antibiotic treatment for preterm labour with intact membranes has no overall benefit for in terms of neonatal outcomes. On the contrary, it increases the risk of neonatal mortality. This treatment is not recommended for routine practice.

RHL Commentary by Isaac Adewole

EVIDENCE SUMMARY

Subclinical and clinical infection have been implicated in the aetiology of preterm labour. This has led to the suggestion that women with preterm labour should be treated with antibiotics in order to reduce the incidence of preterm birth. The Cochrane review found that antibiotic treatment in women with preterm labour with intact membranes reduces maternal infection defined as chorioamnionitis or endometritis (Relative risk [RR]: 0.74; 95% Confidence interval [CI]: 0.64 to 0.87) but has no effect on reduction of preterm birth or adverse neonatal outcomes.

All identifiable, well-controlled trials have been included and analysed satisfactorily.

The full RHL commentary also includes sections on:

Relevance
- Magnitude of the problem
- Feasibility of the intervention
- Applicability of the results of the Cochrane Review
- Implementation of the intervention
- Research
References

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This document should be cited as: Isaac Adewole. Antibiotics in preterm labour with intact membranes: RHL commentary (last revised: 15 November 2002). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com