Antibiotics for spontaneous preterm birth

doi:10.1136/bmj.a3015

Published 30 December 2008, doi:10.1136/bmj.a3015
Cite this as: BMJ 2008;337:a3015

Editorials

Antibiotics for spontaneous preterm birth

Can cause harm, so should be used only after careful consideration

The first 150 words of the full text of this article appear below.

The incidence of preterm birth (<37 weeks’ gestation)is rising. Preterm birth currently occurs in 7.6% of live birthsin England and Wales and 12.5% of births in the United States,where the annual cost exceeds $26.2bn (£17.5bn; ${euro}$ 20bn).¹Up to three quarters of these births have a spontaneous onset.Evidence that labour is associated with an inflammatory processis increasing.²

Very preterm birth (<32 weeks) is commonly associated withinfection³; micro-organisms usually gain access to the sterileuterine cavity by ascending from the vagina. Other routes includehaematogenous spread, iatrogenic introduction, and retrogradespread through the fallopian tubes. The risk of preterm birthis higher with pyelonephritis and bacterial vaginosis. Intrauterineactivation of prostaglandins and phospholipase A2 by micro-organismsmay cause contractions or preterm rupture of the membranes.⁴Infection can also cause neurological damage and cerebral palsy.³

It would seem logical to use antibiotics to tackle this insult. . . [Full text of this article]

Andrew H Shennan, professor of obstetrics, Manju Chandiramani, clinical research fellow

¹ King’s College London Division of Reproduction and Endocrinology, Department of Women’s Health, London SE1 7EH

andrew.shennan@kcl.ac.uk

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Rapid Responses:

Read all Rapid Responses

ORACLE 1 and cerebral palsy.: Andrew Shennan
bmj.com, 7 Jan 2009 [Full text]
Darwin's 200year message: David J R Hutchon
bmj.com, 13 Feb 2009 [Full text]
Antibiotics for the prevention of preterm birth: Ronald F Lamont
bmj.com, 26 Feb 2009 [Full text]