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

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Title: Intrapartum antibiotic exposure and early neonatal, morbidity, and mortality in Africa.
Authors: Kafulafula G (AUTHOR), Mwatha A (AUTHOR), Chen YQ (AUTHOR), Aboud S (AUTHOR), Martinson F (AUTHOR), Hoffman I (AUTHOR), Fawzi W (AUTHOR), Read JS (AUTHOR), Valentine M (AUTHOR), Mwinga K (AUTHOR), Goldenberg R (AUTHOR), Taha TE (AUTHOR)
Source: Pediatrics. Jul2009, Vol. 124 Issue 1, pe137-44. 1p.
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. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Intrapartum antibiotic exposure and early neonatal, morbidity, and mortality in Africa.
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  Data: <searchLink fieldCode="AR" term="%22Kafulafula+G%22">Kafulafula G</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mwatha+A%22">Mwatha A</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen+YQ%22">Chen YQ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aboud+S%22">Aboud S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Martinson+F%22">Martinson F</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hoffman+I%22">Hoffman I</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fawzi+W%22">Fawzi W</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Read+JS%22">Read JS</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Valentine+M%22">Valentine M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mwinga+K%22">Mwinga K</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Goldenberg+R%22">Goldenberg R</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Taha+TE%22">Taha TE</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Jul2009, Vol. 124 Issue 1, pe137-44. 1p.
– Name: Abstract
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  Group: Ab
  Data: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Jul2009
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