Researchers have emphasised the importance of long term follow-up of clinical trials after finding that giving antibiotics to some women in preterm labour raises the risk of cerebral palsy and mild functional problems in their children.

The results from the seven year follow up of the ORACLE I and ORACLE II studies show that women in preterm labour with intact membranes who were treated with erythromycin were 18% (95% confidence interval 2% to 37%) more likely to have a child with a functional impairment than women given placebo (Lancet 2008 Sep 18, doi:10.1016/S0140-6736(08)61202-7 and doi:10.1016/S0140-6736(08)61203-9).

The original ORACLE studies were published in 2001 and led to changes in the care of women in premature labour in the United Kingdom and around the world (Lancet 2001;357:981-90 and 991-6).

They found that antibiotics can benefit women in preterm labour provided their waters have broken, but that the two antibiotics studied, erythromycin and co-amoxiclav, do not delay birth or improve the survival or health of babies whose mothers have intact membranes.

Another finding, that co-amoxiclav raised the risk of necrotising enterocolitis in newborn babies, led to the recommendation by the Royal College of Obstetricians and Gynaecologists that erythromycin and not co-amoxiclav should be given to women whose membranes had ruptured prematurely and who could have …