BMC Pregnancy and Childbirth | |
Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review | |
Research Article | |
Colin Stewart Brown1  Esther R. Robinson2  Karoline Freeman3  Samantha Ann Johnson3  Sian Taylor-Phillips3  Farah Seedat3  Noel Denis McCarthy3  Chris Stinton3  Jacoby Patterson3  Julia Geppert3  Hannah Fraser3  Olalekan A. Uthman3  Aileen Clarke3  Bee Tan4  | |
[1] Bacteria Reference Department, National Infection Service, Public Health England, 61 Colindale Ave, NW95EQ, London, UK;Birmingham Public Health Laboratory (PHE), Heartlands Hospital, B9 5SS, Birmingham, UK;Division of Health Sciences, University of Warwick Medical School, Gibbet Hill Campus, CV4 7AL, Coventry, UK;Division of Health Sciences, University of Warwick Medical School, Gibbet Hill Campus, CV4 7AL, Coventry, UK;Department of Obstetrics and Gynaecology, Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust, B9 5SS, Birmingham, UK; | |
关键词: Streptococcus agalactiae; Streptococcus; Intrapartum antibiotic prophylaxis; Adverse events; Harms; Systematic review; | |
DOI : 10.1186/s12884-017-1432-3 | |
received in 2017-02-28, accepted in 2017-07-18, 发布年份 2017 | |
来源: Springer | |
【 摘 要 】
BackgroundAdverse events from intrapartum antibiotic prophylaxis (IAP) are poorly documented yet essential to inform clinical practice for neonatal group B Streptococcus (GBS) disease prevention. In this systematic review, we appraised and synthesised the evidence on the adverse events of IAP in the mother and/or her child.MethodsWe searched MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Cochrane, and Science Citation Index from date of inception until October 16th 2016. Reference lists of included studies and relevant systematic reviews were hand-searched. We included primary studies in English that reported any adverse events from intrapartum antibiotics for any prophylactic purpose compared to controls. The search was not restricted to prophylaxis for GBS but excluded women with symptoms of infection or undergoing caesarean section. Two reviewers assessed the methodological quality of studies, using the Cochrane Risk of Bias tool, and the Risk of Bias Assessment Tool for Nonrandomised Studies. Results were synthesised narratively and displayed in text and tables.ResultsFrom 2364 unique records, 30 studies were included. Despite a wide range of adverse events reported in 17 observational studies and 13 randomised controlled trials (RCTs), the evidence was inconsistent and at high risk of bias. Only one RCT investigated the long-term effects of IAP reporting potentially serious outcomes such as cerebral palsy; however, it had limited applicability and unclear biological plausibility. Seven observational studies showed that IAP for maternal GBS colonisation alters the infant microbiome. However, study populations were not followed through to clinical outcomes, therefore clinical significance is unknown. There was also observational evidence for increased antimicrobial resistance, however studies were at high or unclear risk of bias.ConclusionsThe evidence base to determine the frequency of adverse events from intrapartum antibiotic prophylaxis for neonatal GBS disease prevention is limited. As RCTs may not be possible, large, better quality, and longitudinal observational studies across countries with widespread IAP could fill this gap.Trial registrationCRD42016037195.
【 授权许可】
CC BY
© The Author(s). 2017
【 预 览 】
Files | Size | Format | View |
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RO202311096669474ZK.pdf | 723KB | download |
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