Dataset Information

Intrapartum antibiotic exposure and early neonatal, morbidity, and mortality in Africa.

ABSTRACT:

Background

Infants born to women who receive intrapartum antibiotics may have higher rates of infectious morbidity and mortality than unexposed infants.

Objective

Our goal was to determine the association of maternal intrapartum antibiotics and early neonatal morbidity and mortality.

Methods

We performed secondary analysis of data from a multisite randomized, placebo-controlled clinical trial of antibiotics to prevent chorioamnionitis-associated mother-to-child transmission of HIV-1 and preterm birth in sub-Saharan Africa. Early neonatal morbidity and mortality were analyzed. In an intention-to-treat (ITT) analysis, infants born to women randomly assigned to antibiotics or placebo were compared. In addition, non-ITT analysis was performed because some women received nonstudy antibiotics for various clinical indications.

Results

Overall, 2659 pregnant women were randomly assigned. Of these, 2466 HIV-1-infected and HIV-1-uninfected women delivered 2413 live born and 84 stillborn infants. In the ITT analysis, there were no significant associations between exposure to antibiotics and early neonatal outcomes. Non-ITT analyses showed more illness at birth (11.2% vs 8.6%, P = .03) and more admissions to the special care infant unit (12.6% vs 9.8%, P = .04) among infants exposed to maternal intrapartum antibiotics than among unexposed infants. Additional analyses revealed greater early neonatal morbidity and mortality among infants of mothers who received nonstudy antibiotics than of mothers who received study antibiotics.

Conclusions

There is no association between intrapartum exposure to antibiotics and early neonatal morbidity or mortality. The associations observed in non-ITT analyses are most likely the result of women with peripartum illnesses being more likely to receive nonstudy antibiotics.

SUBMITTER: Kafulafula G

PROVIDER: S-EPMC2764263 | biostudies-literature | 2009 Jul

REPOSITORIES: biostudies-literature

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Publications

Intrapartum antibiotic exposure and early neonatal, morbidity, and mortality in Africa.

Kafulafula George G Mwatha Anthony A Chen Ying Qing YQ Aboud Said S Martinson Francis F Hoffman Irving I Fawzi Wafaie W Read Jennifer S JS Valentine Megan M Mwinga Kasonde K Goldenberg Robert R Taha Taha E TE

Pediatrics 20090701 1

<h4>Background</h4>Infants born to women who receive intrapartum antibiotics may have higher rates of infectious morbidity and mortality than unexposed infants.<h4>Objective</h4>Our goal was to determine the association of maternal intrapartum antibiotics and early neonatal morbidity and mortality.<h4>Methods</h4>We performed secondary analysis of data from a multisite randomized, placebo-controlled clinical trial of antibiotics to prevent chorioamnionitis-associated mother-to-child transmission ...[more]

PMID: 19564260

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Dataset Information

Intrapartum antibiotic exposure and early neonatal, morbidity, and mortality in Africa.

Background

Objective

Methods

Results

Conclusions

Publications

Intrapartum antibiotic exposure and early neonatal, morbidity, and mortality in Africa.

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