Antimicrobial prophylaxis in pregnancy: A randomized, placebo-controlled trial with cefetamet-pivoxil in pregnant women with a poor obstetric history☆,☆☆,★,★★
Section snippets
Patients and methods
Women with a poor obstetric history attending the mother-child health clinic of Pumwani Maternity Hospital in Nairobi, Kenya, were invited to participate in the study at a gestational age of 28 to 32 weeks. Poor obstetric history was defined as a history of preterm birth (<37 weeks), LBW (<2500 gm), stillbirth, or early perinatal mortality. Stillbirth and early neonatal mortality were included because a large proportion of perinatal mortality was the result of prematurity, but mothers often did
Results
Between November 1995 and February 1996, 320 pregnant women were enrolled in the study, 160 in the cefetamet-pivoxil group and 160 in the placebo arm. No women refused to participate. The first antenatal visit was around 24 weeks of pregnancy. The two groups were comparable with regard to age, marital status, parity, and obstetric history (variables listed in Table I). The mean gestational age, based on the LMP and clinical estimates, at enrollment was 30 weeks. Eighty-three percent of patients
Comment
Our data suggest an effect of a broad-spectrum antibiotic treatment during pregnancy on the infant's birth weight. In a population with high rates of sexually transmitted diseases antenatal case detection and treatment of gonorrhea and other sexually transmitted diseases during pregnancy is the obvious solution to this problem but there are major logistic impediments to its implementation. Diagnostic algorithms for cervical infection, on the basis of clinical signs and symptoms or on behavioral
Acknowledgements
We thank Dr. Louis Haller from the Roche African Research Foundation, Abidjan, Ivory Coast, for helpful discussions and useful comments.
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Determination of antibiotic concentration in meconium and its association with fetal growth and development
2019, Environment InternationalCitation Excerpt :Antibiotic exposure can originate from their direct use or contaminated food and water environment. Because most of the exposure measurement is based on questionnaire survey or prescription information, current epidemiological studies inevitably ignore antibiotic exposures from contaminated food and water environment (Czeizel et al., 1998; Elder et al., 1971; Gichangi et al., 1997; Jepsen et al., 2003; Kass et al., 1981; Mccormack et al., 1987; Mcgregor et al., 1986; Mueller et al., 2017; Temmerman et al., 1995). The biomonitoring approach of antibiotic exposure can overcome this problem by measuring the internal exposure dose resulting from various exposure sources (Wang et al., 2016a).
Care for women with prior preterm birth
2010, American Journal of Obstetrics and GynecologyGoals and Strategies for Prevention of Preterm Birth: An Obstetric Perspective
2009, Pediatric Clinics of North AmericaCitation Excerpt :Treatment of asymptomatic bacteriuria reduces the rate of preterm birth,71,72,191 but the value of antibiotic treatment to reduce the risk of preterm birth in women who have genital colonization or infection is uncertain. In previous studies, women were enrolled on the basis of obstetric history,27,192–194 detection of bacterial vaginosis (BV; an alteration in the vaginal ecosystem),195–204 colonization with a specific microorganism (T vaginalis,25 group B streptococcus,75 or Ureaplasma urealyticum74) or after a positive test for cervicovaginal fetal fibronectin, a marker for disturbance of the fetal–maternal interface.26,27 Trials of treatment for BV-positive women vary in timing, dosage, and choice of antibiotic treatment and show conflicting results.
The HPTN 024 Study: The efficacy of antibiotics to prevent chorioamnionitis and preterm birth
2006, American Journal of Obstetrics and GynecologyCitation Excerpt :More commonly, to reduce preterm birth, antibiotics are given prophylactically during prenatal care, sometimes targeted at BV, sometimes at a history of preterm birth, and sometimes just at a risk population.18-23 The outcomes of these studies are also varied, but some, and especially 2 African studies,24,25 have suggested some benefit. Because the combination of metronidazole and erythromycin had shown the most success in previous studies,21 and because 1 or both are an appropriate treatment for the organisms likely to be present in the uterus in women in preterm labor, and because they would be affordable in an African setting, these drugs were chosen for antenatal administration in this trial.
Infection as a cause of preterm birth
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From the World Health Organization Centre for Research and Training in Sexually Transmitted Diseases, Department of Medical Microbiology, University of Nairobi,a and the Department of Obstetrics and Gynaecology, University of Ghent.b
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Supported by the International Centre for Reproductive Health, University of Ghent, Ghent, Belgium, and the Roche African Research Foundation, Abidjan, Ivory Coast.
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Reprint requests: Marleen Temmerman, MD, PhD, International Centre for Reproductive Health, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium.
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