Your browser doesn't support javascript.
loading
Antibiotic prophylaxis in preterm premature rupture of membranes at 24-31 weeks' gestation: Perinatal and 2-year outcomes in the EPIPAGE-2 cohort.
Lorthe, Elsa; Letouzey, Mathilde; Torchin, Héloïse; Foix L'Helias, Laurence; Gras-Le Guen, Christèle; Benhammou, Valérie; Boileau, Pascal; Charlier, Caroline; Kayem, Gilles.
Afiliação
  • Lorthe E; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.
  • Letouzey M; Unit of Population Epidemiology, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
  • Torchin H; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.
  • Foix L'Helias L; Department of Neonatal Paediatrics, Poissy Saint Germain Hospital, Versailles Saint Quentin en Yvelines University, Poissy, France.
  • Gras-Le Guen C; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.
  • Benhammou V; Department of Neonatal Paediatrics, Cochin Port Royal Hospital, APHP, Paris, France.
  • Boileau P; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.
  • Charlier C; Department of Neonatal Paediatrics, Trousseau Hospital, APHP, Sorbonne University, Paris, France.
  • Kayem G; Department of Paediatrics, Paediatrics Emergency Unit and General Paediatrics, Nantes University Hospital, Hôpital Mère-Enfant, CHU de Nantes, Nantes, France.
BJOG ; 129(9): 1560-1573, 2022 08.
Article em En | MEDLINE | ID: mdl-34954867
OBJECTIVE: To compare different antibiotic prophylaxis administered after preterm premature rupture of membranes to determine whether any were associated with differences in obstetric and/or neonatal outcomes and/or neurodevelopmental outcomes at 2 years of corrected age. DESIGN: Prospective, nationwide, population-based EPIPAGE-2 cohort study of preterm infants. SETTING: France, 2011. SAMPLE: We included 492 women with a singleton pregnancy and a diagnosis of preterm premature rupture of membranes at 24-31 weeks. Exclusion criteria were contraindication to expectant management or indication for antibiotic therapy other than preterm premature rupture of membranes. Antibiotic prophylaxis was categorised as amoxicillin (n = 345), macrolide (n = 30), third-generation cephalosporin (n = 45) or any combinations covering Streptococcus agalactiae and >90% of Escherichia coli (n = 72), initiated within 24 hours after preterm premature rupture of membranes. METHODS: Population-averaged robust Poisson models. MAIN OUTCOME MEASURES: Survival at discharge without severe neonatal morbidity, 2-year neurodevelopment. RESULTS: With amoxicillin, macrolide, third-generation cephalosporin and combinations, 78.5%, 83.9%, 93.6% and 86.0% of neonates were discharged alive without severe morbidity. The administration of third-generation cephalosporin or any E. coli-targeting combinations was associated with improved survival without severe morbidity (adjusted risk ratio 1.25 [95% confidence interval 1.08-1.45] and 1.10 [95 % confidence interval 1.01-1.20], respectively) compared with amoxicillin. We evidenced no increase in neonatal sepsis related to third-generation cephalosporin-resistant pathogen. CONCLUSION: In preterm premature rupture of membranes at 24-31 weeks, antibiotic prophylaxis based on third-generation cephalosporin may be associated with improved survival without severe neonatal morbidity when compared with amoxicillin, with no evidence of increase in neonatal sepsis related to third-generation cephalosporin-resistant pathogen. TWEETABLE ABSTRACT: Antibiotic prophylaxis after PPROM at 24-31 weeks: 3rd-generation cephalosporins associated with improved neonatal outcomes.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ruptura Prematura de Membranas Fetais / Nascimento Prematuro / Sepse Neonatal Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ruptura Prematura de Membranas Fetais / Nascimento Prematuro / Sepse Neonatal Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article