Antibiotics for ureaplasma in the vagina in pregnancy
Abstract
Background
Preterm birth is a significant obstetric problem in high‐income countries. Genital infection including ureaplasmas are suspected of playing a role in preterm birth and preterm rupture of the membranes. Antibiotics are used to treat women with preterm prelabour rupture of the membranes and results in prolongation of pregnancy and lowers the risks of maternal and neonatal infection. However, antibiotics may be beneficial earlier in pregnancy to eradicate potentially causative agents.
Objectives
The objective of this review is to assess whether antibiotic treatment of pregnant women with ureaplasma in the vagina reduces the incidence of preterm birth and other adverse pregnancy outcomes.
Search methods
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2003). We updated this search on 1 October 2009 and added the results to the awaiting classification section.
Selection criteria
All randomised controlled trials that compared any antibiotic regimen with placebo or no treatment in pregnant women with ureaplasma detected in the vagina.
Data collection and analysis
Three reviewers independently assessed eligibility and trial quality and extracted data.
Main results
One trial involving 1071 women was included. Of these, 644 randomly received antibiotic treatment (174 erythromycin estolate, 224 erythromycin sterate, and 246 clindamycin hydrochloride) and 427 received placebo. This trial did not report data on preterm birth. Incidence of low birthweight less than 2500 grams was only evaluated for erythromycin (combined) (n = 398 ) compared to placebo (n = 427) and there was no statistically significant difference between those treated and those not treated (relative risk (RR) 0.70, 95% confidence interval (CI) 0.46 to 1.07). In regards to side‐effects sufficient to stop treatment, data were available for all women, and there were no statistically significant differences between any antibiotic (combined) and the placebo group (RR 1.25, 95% CI 0.85 to 1.85).
Authors' conclusions
There is insufficient evidence to show whether giving antibiotics to women with ureaplasma in the vagina will prevent preterm birth.
[Note: The three citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]
PICOs
Plain language summary
Antibiotics for ureaplasma in the vagina in pregnancy
Insufficient evidence to show that giving antibiotics to women with ureaplasma in the vagina makes a difference in preventing preterm birth.
Ureaplasmas are normal flora in the vagina of many women. In some women high levels of ureaplasma in the vagina may have a role in pregnancy complications and or contribute to babies being born too early (preterm birth). These babies can have serious health problems. Some antibiotics can be safely used during pregnancy and are also active against ureaplasmas. The reviewers identified only one trial that was eligible for inclusion in the review. There were insufficient data to assess whether giving antibiotics to women with ureaplasma in the vagina makes a difference in preventing preterm birth.
