Perinatology.  2018 Mar;29(1):1-7. 10.14734/PN.2018.29.1.1.

Effects of Antenatal Azithromycin for Ureaplasma spp. on Neonatal Outcomes

• Ko KH
• Chun JY
• Sung TJ

• KMID: 2409105
• DOI: http://doi.org/10.14734/PN.2018.29.1.1

Abstract

OBJECTIVE
Ureaplasma spp. in the maternal genitourinary tract is increasingly known to cause preterm labor, spontaneous abortion, chorioamnionitis and adverse neonatal outcomes. However, controversies still remain regarding whether or not to treat it aggressively. The aim of this study was to evaluate the effects of antenatal azithromycin (AZ) for Ureaplasma urealyticum (UU) infection on neonatal complications in preterm infants.
METHODS
Retrospective single-center case-control study of preterm babies delivered at < 32 weeks' of gestation age (GA) between 2010 and 2014 were conducted. Cases were defined as infants with complete maternal AZ treatment when UU was confirmed and controls were without UU. Cases were matched with controls by birth year, GA, and birth weight. Subgroup analysis according to GA (23⁺0-28⁺6 weeks' and 29⁺0-32⁺6 weeks') were done as well.
RESULTS
Of 169 cases identified 51 with untreated or incompletely treated mother, 26 died or transferred, and four with incomplete chart were excluded; thus 88 preterm infants were matched to 88 controls. Incidence of bronchopulmonary dysplasia (BPD) and early sepsis were same in both group; however, in very preterm infants between 23⁺0 to 28⁺6 weeks' GA, incidence of moderate-to-severe BPD was significantly higher in cases (42% vs. 16%, P=0.022) and incidence of sepsis was significantly lower (8% vs. 26%, P=0.033).
CONCLUSION
Maternal UU was associated with moderate-to-severe BPD even though AZ treatment was done. Early sepsis was significantly less developed with prenatal antibiotics at ≤28 weeks' GA. Hence selective antenatal azithromycin therapy of UU is still needed for improving neonatal outcomes.

Keyword

Cervical Cerclage; Cervical length measurement; Uterine cervical incompetence; Premature birth

MeSH Terms

Abortion, Spontaneous
Anti-Bacterial Agents
Azithromycin*
Birth Weight
Bronchopulmonary Dysplasia
Case-Control Studies
Cerclage, Cervical
Cervical Length Measurement
Chorioamnionitis
Female
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature
Mothers
Obstetric Labor, Premature
Parturition
Pregnancy
Premature Birth
Retrospective Studies
Sepsis
Ureaplasma urealyticum
Ureaplasma*
Uterine Cervical Incompetence
Anti-Bacterial Agents
Azithromycin

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