Antibiotics to treat and prevent infection during preterm labor

Treatment with antibiotics

Types of infections that can cause pregnancy problems include syphilis, chlamydia, gonorrhea, group B strep, urinary tract infection, and pneumonia.

Infections during pregnancy are treated with antibiotics. The type of antibiotic used to treat the infection depends on which bacteria are causing the infection. Antibiotics commonly used during pregnancy include erythromycin, clindamycin, ampicillin, gentamycin, and metronidazole.

Antibiotics do not always clear up uterine infection or prevent preterm labor.¹ If a mother's uterus has become infected and her fetus is mature enough, her doctor or nurse-midwife might not attempt to delay the birth.

Prevention with antibiotics after preterm premature rupture of membranes (pPROM)

Preterm premature rupture of membranes (pPROM) is the rupture of the amniotic sac before 37 completed weeks of pregnancy. A recent review of research demonstrates that antibiotics, when given to women with pPROM, can:²

• Increase time from pPROM to delivery.
• Decrease the risk of infection in the vagina and uterus.
• Decrease the risk of fetal infection.

Prevention with antibiotics with intact membranes

Antibiotics are not a recommended treatment for women in preterm labor whose amniotic sac has not ruptured (intact membranes). A recent large study suggests that this treatment does not delay premature birth.³ However, some women do receive antibiotics for group B strep prevention or treatment.

Citations

1. Goldenberg RL, et al. (2000). Intrauterine infection and preterm delivery. New England Journal of Medicine, 342(20): 1500–1507.

2. Haas DM (2005). Preterm birth, search date June 2005. Online version of Clinical Evidence (14): 1–20.

3. Kenyon S, et al. (2001). Broad-spectrum antibiotics for spontaneous preterm labour: The ORACLE II randomised trial. Lancet, 357(9261): 989–994.

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