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Antibióticos para la rotura prematura de membranas

Appendices

Appendix 1. Methods used to assess trials included in a previous version of this review (published 2003, Issue 2).

The following methods were used to assess Almeida 1996; Amon 1988a; Camli 1997; Christmas 1992; Cox 1995; Ernest 1994; Garcia‐Burguillo 1995; Grable 1996; Johnston 1990; Kenyon 2001; Kurki 1992; Lewis 2003; Lockwood 1993a; Magwali 1999; McGregor 1991; Mercer 1992; Mercer 1997; Morales 1989; Ovalle‐Salas 1997; Owen 1993a; Segel 2003; Svare 1997a.

All trials identified by the methods described in the search strategy were scrutinised by the reviewers. We processed included trial data as described in Alderson 2004. We evaluated trials under consideration for inclusion and methodological quality. There was no blinding of authorship. We assigned quality scores for concealment of allocation to each trial, using the criteria described in section six of the Cochrane Reviewers' Handbook (Alderson 2004): A = adequate; B = unclear; C = inadequate; D = not used.

We excluded trials that proved on closer examination not to be true randomised trials. We analysed outcomes on an intention‐to‐treat basis.

We extracted and double entered data. Wherever possible, we sought unpublished data from the investigator. Where outcomes were published in the form of percentages or graphs, the number of events were calculated. Where maternal outcomes were presented, numerators and denominators were calculated based on the number of mothers. Babies from multiple pregnancies have been treated as a single unit, with the worst outcome among the babies included in analyses. Of the 22 trials included, 12 only randomised singletons. Of the seven remaining, two did not state whether multiples were included. Of the five trials that included multiples, two specified how they had analysed the data (Kenyon 2001; Mercer 1997) and both used the worst outcomes in any baby.

We tested for heterogeneity between trial results using a standard Chi‐squared test. For dichotomous data, we calculated the relative risk and for continuous variables, the weighted mean difference; in both cases, we reported 95% confidence intervals.

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figures and Tables -
Figure 1

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.3 Perinatal death/death before discharge.
Figures and Tables -
Figure 2

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.3 Perinatal death/death before discharge.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.4 Neonatal infection including pneumonia.
Figures and Tables -
Figure 3

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.4 Neonatal infection including pneumonia.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.5 Neonatal necrotising enterocolitis.
Figures and Tables -
Figure 4

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.5 Neonatal necrotising enterocolitis.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.7 Major cerebral abnormality on ultrasound before discharge.
Figures and Tables -
Figure 5

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.7 Major cerebral abnormality on ultrasound before discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 1 Maternal death.
Figures and Tables -
Analysis 1.1

Comparison 1 Any antibiotic versus placebo, Outcome 1 Maternal death.

Comparison 1 Any antibiotic versus placebo, Outcome 3 Perinatal death/death before discharge.
Figures and Tables -
Analysis 1.3

Comparison 1 Any antibiotic versus placebo, Outcome 3 Perinatal death/death before discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 4 Neonatal infection including pneumonia.
Figures and Tables -
Analysis 1.4

Comparison 1 Any antibiotic versus placebo, Outcome 4 Neonatal infection including pneumonia.

Comparison 1 Any antibiotic versus placebo, Outcome 5 Neonatal necrotising enterocolitis.
Figures and Tables -
Analysis 1.5

Comparison 1 Any antibiotic versus placebo, Outcome 5 Neonatal necrotising enterocolitis.

Comparison 1 Any antibiotic versus placebo, Outcome 6 Oxygen treatment > 36 weeks' postconceptual age.
Figures and Tables -
Analysis 1.6

Comparison 1 Any antibiotic versus placebo, Outcome 6 Oxygen treatment > 36 weeks' postconceptual age.

Comparison 1 Any antibiotic versus placebo, Outcome 7 Major cerebral abnormality on ultrasound before discharge.
Figures and Tables -
Analysis 1.7

Comparison 1 Any antibiotic versus placebo, Outcome 7 Major cerebral abnormality on ultrasound before discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 8 Birth before 37 weeks' gestation.
Figures and Tables -
Analysis 1.8

Comparison 1 Any antibiotic versus placebo, Outcome 8 Birth before 37 weeks' gestation.

Comparison 1 Any antibiotic versus placebo, Outcome 9 Major adverse drug reaction.
Figures and Tables -
Analysis 1.9

Comparison 1 Any antibiotic versus placebo, Outcome 9 Major adverse drug reaction.

Comparison 1 Any antibiotic versus placebo, Outcome 10 Maternal infection after delivery prior to discharge.
Figures and Tables -
Analysis 1.10

Comparison 1 Any antibiotic versus placebo, Outcome 10 Maternal infection after delivery prior to discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 11 Chorioamnionitis.
Figures and Tables -
Analysis 1.11

Comparison 1 Any antibiotic versus placebo, Outcome 11 Chorioamnionitis.

Comparison 1 Any antibiotic versus placebo, Outcome 12 Caesarean section.
Figures and Tables -
Analysis 1.12

Comparison 1 Any antibiotic versus placebo, Outcome 12 Caesarean section.

Comparison 1 Any antibiotic versus placebo, Outcome 15 Birth within 48 hours of randomisation.
Figures and Tables -
Analysis 1.15

Comparison 1 Any antibiotic versus placebo, Outcome 15 Birth within 48 hours of randomisation.

Comparison 1 Any antibiotic versus placebo, Outcome 16 Birth within 7 days of randomisation.
Figures and Tables -
Analysis 1.16

Comparison 1 Any antibiotic versus placebo, Outcome 16 Birth within 7 days of randomisation.

Comparison 1 Any antibiotic versus placebo, Outcome 17 Birthweight.
Figures and Tables -
Analysis 1.17

Comparison 1 Any antibiotic versus placebo, Outcome 17 Birthweight.

Comparison 1 Any antibiotic versus placebo, Outcome 18 Birthweight < 2500 g.
Figures and Tables -
Analysis 1.18

Comparison 1 Any antibiotic versus placebo, Outcome 18 Birthweight < 2500 g.

Comparison 1 Any antibiotic versus placebo, Outcome 19 Neonatal intensive care.
Figures and Tables -
Analysis 1.19

Comparison 1 Any antibiotic versus placebo, Outcome 19 Neonatal intensive care.

Comparison 1 Any antibiotic versus placebo, Outcome 20 Days in neonatal intensive care unit.
Figures and Tables -
Analysis 1.20

Comparison 1 Any antibiotic versus placebo, Outcome 20 Days in neonatal intensive care unit.

Comparison 1 Any antibiotic versus placebo, Outcome 21 Positive neonatal blood culture.
Figures and Tables -
Analysis 1.21

Comparison 1 Any antibiotic versus placebo, Outcome 21 Positive neonatal blood culture.

Comparison 1 Any antibiotic versus placebo, Outcome 22 Neonatal respiratory distress syndrome.
Figures and Tables -
Analysis 1.22

Comparison 1 Any antibiotic versus placebo, Outcome 22 Neonatal respiratory distress syndrome.

Comparison 1 Any antibiotic versus placebo, Outcome 23 Treatment with surfactant.
Figures and Tables -
Analysis 1.23

Comparison 1 Any antibiotic versus placebo, Outcome 23 Treatment with surfactant.

Comparison 1 Any antibiotic versus placebo, Outcome 24 Number of babies requiring ventilation.
Figures and Tables -
Analysis 1.24

Comparison 1 Any antibiotic versus placebo, Outcome 24 Number of babies requiring ventilation.

Comparison 1 Any antibiotic versus placebo, Outcome 25 Number of babies requiring oxygen therapy.
Figures and Tables -
Analysis 1.25

Comparison 1 Any antibiotic versus placebo, Outcome 25 Number of babies requiring oxygen therapy.

Comparison 1 Any antibiotic versus placebo, Outcome 26 Neonatal oxygenation > 28 days.
Figures and Tables -
Analysis 1.26

Comparison 1 Any antibiotic versus placebo, Outcome 26 Neonatal oxygenation > 28 days.

Comparison 1 Any antibiotic versus placebo, Outcome 27 Neonatal encephalopathy.
Figures and Tables -
Analysis 1.27

Comparison 1 Any antibiotic versus placebo, Outcome 27 Neonatal encephalopathy.

Comparison 1 Any antibiotic versus placebo, Outcome 28 Serious childhood disability at 7 years.
Figures and Tables -
Analysis 1.28

Comparison 1 Any antibiotic versus placebo, Outcome 28 Serious childhood disability at 7 years.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 3 Major adverse drug reaction.
Figures and Tables -
Analysis 2.3

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 3 Major adverse drug reaction.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 4 Maternal infection after delivery prior to discharge.
Figures and Tables -
Analysis 2.4

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 4 Maternal infection after delivery prior to discharge.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 6 Caesarean section.
Figures and Tables -
Analysis 2.6

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 6 Caesarean section.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 9 Birth within 48 hours of randomisation.
Figures and Tables -
Analysis 2.9

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 9 Birth within 48 hours of randomisation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 10 Birth within 7 days of randomisation.
Figures and Tables -
Analysis 2.10

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 10 Birth within 7 days of randomisation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 11 Birth before 37 weeks' gestation.
Figures and Tables -
Analysis 2.11

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 11 Birth before 37 weeks' gestation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 12 Birthweight.
Figures and Tables -
Analysis 2.12

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 12 Birthweight.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 13 Birthweight < 2500 g.
Figures and Tables -
Analysis 2.13

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 13 Birthweight < 2500 g.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 14 Neonatal intensive care.
Figures and Tables -
Analysis 2.14

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 14 Neonatal intensive care.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 17 Positive neonatal blood culture.
Figures and Tables -
Analysis 2.17

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 17 Positive neonatal blood culture.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 18 Neonatal necrotising enterocolitis.
Figures and Tables -
Analysis 2.18

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 18 Neonatal necrotising enterocolitis.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 19 Neonatal respiratory distress syndrome.
Figures and Tables -
Analysis 2.19

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 19 Neonatal respiratory distress syndrome.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 20 Treatment with surfactant.
Figures and Tables -
Analysis 2.20

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 20 Treatment with surfactant.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 21 Number of babies requiring ventilation.
Figures and Tables -
Analysis 2.21

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 21 Number of babies requiring ventilation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 22 Number of babies requiring oxygen therapy.
Figures and Tables -
Analysis 2.22

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 22 Number of babies requiring oxygen therapy.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 23 Neonatal oxygenation > 28 days.
Figures and Tables -
Analysis 2.23

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 23 Neonatal oxygenation > 28 days.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 24 Oxygen treatment > 36 weeks' postconceptual age.
Figures and Tables -
Analysis 2.24

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 24 Oxygen treatment > 36 weeks' postconceptual age.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 26 Major cerebral abnormality on ultrasound before discharge.
Figures and Tables -
Analysis 2.26

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 26 Major cerebral abnormality on ultrasound before discharge.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 27 Perinatal death/death before discharge.
Figures and Tables -
Analysis 2.27

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 27 Perinatal death/death before discharge.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 28 Serious childhood disability at 7 years.
Figures and Tables -
Analysis 2.28

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 28 Serious childhood disability at 7 years.

Comparison 4 Antibiotics versus no antibiotic, Outcome 1 Perinatal death/death before discharge.
Figures and Tables -
Analysis 4.1

Comparison 4 Antibiotics versus no antibiotic, Outcome 1 Perinatal death/death before discharge.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 4 Maternal infection after delivery prior to discharge.
Figures and Tables -
Analysis 5.4

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 4 Maternal infection after delivery prior to discharge.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 5 Chorioamnionitis.
Figures and Tables -
Analysis 5.5

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 5 Chorioamnionitis.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 6 Caesarean section.
Figures and Tables -
Analysis 5.6

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 6 Caesarean section.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 9 Birth within 48 hours of randomisation.
Figures and Tables -
Analysis 5.9

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 9 Birth within 48 hours of randomisation.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 10 Birth within 7 days of randomisation.
Figures and Tables -
Analysis 5.10

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 10 Birth within 7 days of randomisation.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 14 Neonatal intensive care.
Figures and Tables -
Analysis 5.14

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 14 Neonatal intensive care.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 18 Neonatal necrotising enterocolitis.
Figures and Tables -
Analysis 5.18

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 18 Neonatal necrotising enterocolitis.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 19 Neonatal respiratory distress syndrome.
Figures and Tables -
Analysis 5.19

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 19 Neonatal respiratory distress syndrome.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 26 Neonatal intraventricular haemorrhage.
Figures and Tables -
Analysis 5.26

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 26 Neonatal intraventricular haemorrhage.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 27 Perinatal death/death before discharge.
Figures and Tables -
Analysis 5.27

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 27 Perinatal death/death before discharge.

Comparison 1. Any antibiotic versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Maternal death Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Any antibiotic versus placebo

3

763

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 All penicillin (excluding co‐amoxiclav) versus placebo

1

85

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Beta lactum (including co‐amoxiclav) versus placebo 

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Macrolide (including erythromycin) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.5 Other antibiotic versus placebo

2

678

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Serious maternal morbidity

0

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Any antibiotic versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 All penicillin (excluding co‐amoxiclav) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Beta lactum (including co‐amoxiclav) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 Macrolide (including erythromycin) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.5 Other antibiotic versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Perinatal death/death before discharge Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Any antibiotic versus placebo

12

6301

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.76, 1.14]

3.2 All penicillin (excluding co‐amoxiclav) versus placebo

4

332

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.31, 1.97]

3.3 Beta lactum (including co‐amoxiclav) versus placebo

2

1880

Risk Ratio (M‐H, Random, 95% CI)

0.62 [0.15, 2.56]

3.4 Macrolide (including erythromycin) versus placebo

4

2138

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.43, 1.60]

3.5 Other antibiotic versus placebo

3

762

Risk Ratio (M‐H, Random, 95% CI)

1.13 [0.68, 1.88]

4 Neonatal infection including pneumonia Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Any antibiotic versus placebo

12

1680

Risk Ratio (M‐H, Random, 95% CI)

0.67 [0.52, 0.85]

4.2 All penicillin (excluding co‐amoxiclav) versus placebo

5

521

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.13, 0.68]

4.3 Beta lactum (including co‐amoxiclav) versus placebo

1

62

Risk Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 7.88]

4.4 Macrolide (including erythromycin) versus placebo

3

334

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.45, 1.37]

4.5 Other antibiotic versus placebo

3

763

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.53, 0.95]

5 Neonatal necrotising enterocolitis Show forest plot

11

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

5.1 Any antibiotic versus placebo

11

6229

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.65, 1.83]

5.2 All penicillin (excluding co‐amoxiclav) versus placebo

3

262

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.25, 2.97]

5.3 Beta lactum (including co‐amoxiclav) versus placebo

2

1880

Risk Ratio (M‐H, Random, 95% CI)

4.72 [1.57, 14.23]

5.4 Macrolide (including erythromycin) versus placebo

3

2076

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.45, 1.69]

5.5 Other antibiotic versus placebo

4

823

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.54, 1.47]

6 Oxygen treatment > 36 weeks' postconceptual age Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Any antibiotic versus placebo

1

4809

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.70, 1.17]

6.2 All penicillin (excluding co‐amoxiclav) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Beta lactum (including co‐amoxiclav) versus placebo

1

1818

Risk Ratio (M‐H, Random, 95% CI)

0.92 [0.63, 1.36]

6.4 Macrolide (including erythromycin) versus placebo

1

1803

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.61, 1.32]

6.5 Other antibiotic versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Major cerebral abnormality on ultrasound before discharge Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

7.1 Any antibiotic versus placebo

12

6289

Risk Ratio (M‐H, Random, 95% CI)

0.81 [0.68, 0.98]

7.2 All penicillin (excluding co‐amoxiclav) versus placebo 

3

262

Risk Ratio (M‐H, Random, 95% CI)

0.49 [0.25, 0.96]

7.3 Beta lactum (including co‐amoxiclav) versus placebo

2

1880

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.52, 1.16]

7.4 Macrolide (including erythromycin) versus placebo 

4

2136

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.60, 1.44]

7.5 Other antibiotic versus placebo

4

823

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.45, 1.64]

8 Birth before 37 weeks' gestation Show forest plot

3

4931

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.98, 1.03]

9 Major adverse drug reaction Show forest plot

3

5487

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Maternal infection after delivery prior to discharge Show forest plot

4

5547

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.80, 1.02]

11 Chorioamnionitis Show forest plot

11

1559

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.46, 0.96]

12 Caesarean section Show forest plot

11

6317

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.88, 1.05]

13 Days from birth till discharge of mother

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

14 Days from randomisation to birth

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

15 Birth within 48 hours of randomisation Show forest plot

7

5927

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.58, 0.87]

16 Birth within 7 days of randomisation Show forest plot

7

5965

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.71, 0.89]

17 Birthweight Show forest plot

12

6374

Mean Difference (IV, Random, 95% CI)

53.83 [7.06, 100.60]

18 Birthweight < 2500 g Show forest plot

2

4876

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.96, 1.04]

19 Neonatal intensive care Show forest plot

4

5023

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.84, 1.13]

20 Days in neonatal intensive care unit Show forest plot

3

225

Mean Difference (IV, Random, 95% CI)

‐5.05 [‐9.77, ‐0.33]

21 Positive neonatal blood culture Show forest plot

3

4961

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.63, 0.99]

22 Neonatal respiratory distress syndrome Show forest plot

12

6287

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.83, 1.09]

23 Treatment with surfactant Show forest plot

1

4809

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.72, 0.96]

24 Number of babies requiring ventilation Show forest plot

2

4924

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.80, 1.02]

25 Number of babies requiring oxygen therapy Show forest plot

1

4809

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.81, 0.96]

26 Neonatal oxygenation > 28 days Show forest plot

3

5487

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.61, 1.03]

27 Neonatal encephalopathy Show forest plot

1

60

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

28 Serious childhood disability at 7 years Show forest plot

1

3171

Risk Ratio (M‐H, Random, 95% CI)

1.01 [0.91, 1.12]

Figures and Tables -
Comparison 1. Any antibiotic versus placebo
Comparison 2. Erythromycin versus co‐amoxiclav

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Maternal death

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Serious maternal morbidity

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Major adverse drug reaction Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Maternal infection after delivery prior to discharge Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.87, 1.20]

5 Chorioamnionitis

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6 Caesarean section Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.90, 1.16]

7 Days from randomisation to birth

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

8 Days from birth till discharge of mother

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

9 Birth within 48 hours of randomisation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.14 [1.02, 1.28]

10 Birth within 7 days of randomisation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.06 [0.99, 1.13]

11 Birth before 37 weeks' gestation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.99 [0.96, 1.03]

12 Birthweight Show forest plot

1

2395

Mean Difference (IV, Random, 95% CI)

19.0 [‐41.92, 79.92]

13 Birthweight < 2500 g Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.95, 1.05]

14 Neonatal intensive care Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.95, 1.05]

15 Days in neonatal intensive care unit

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

16 Neonatal infection including pneumonia

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

17 Positive neonatal blood culture Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.84 [0.62, 1.15]

18 Neonatal necrotising enterocolitis Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.46 [0.23, 0.94]

19 Neonatal respiratory distress syndrome Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.99 [0.84, 1.16]

20 Treatment with surfactant Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.81, 1.19]

21 Number of babies requiring ventilation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.86, 1.17]

22 Number of babies requiring oxygen therapy Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.87, 1.10]

23 Neonatal oxygenation > 28 days Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.86 [0.66, 1.12]

24 Oxygen treatment > 36 weeks' postconceptual age Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.70, 1.34]

25 Neonatal encephalopathy

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

26 Major cerebral abnormality on ultrasound before discharge Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.10 [0.74, 1.63]

27 Perinatal death/death before discharge Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.66, 1.23]

28 Serious childhood disability at 7 years Show forest plot

1

1612

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.79, 1.01]

Figures and Tables -
Comparison 2. Erythromycin versus co‐amoxiclav
Comparison 4. Antibiotics versus no antibiotic

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Perinatal death/death before discharge Show forest plot

18

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Antibiotics versus no antibiotics (all studies)

18

6872

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.74, 1.08]

1.2 Antibiotics versus no treatment (no placebo)

6

571

Risk Ratio (M‐H, Random, 95% CI)

0.69 [0.41, 1.14]

Figures and Tables -
Comparison 4. Antibiotics versus no antibiotic
Comparison 5. 3 versus 7 day ampicillin regimens

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Maternal death

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Serious maternal morbidity

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Major adverse drug reaction

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Maternal infection after delivery prior to discharge Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.25 [0.36, 4.33]

5 Chorioamnionitis Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.33, 1.63]

6 Caesarean section Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.18 [0.72, 1.91]

7 Days from randomisation to birth

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

8 Days from birth till discharge of mother

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

9 Birth within 48 hours of randomisation Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.14 [0.46, 2.87]

10 Birth within 7 days of randomisation Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.0 [0.70, 1.42]

11 Birth before 37 weeks' gestation

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12 Birthweight

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

13 Birthweight < 2500 g

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

14 Neonatal intensive care Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.0 [0.84, 1.19]

15 Days in neonatal intensive care unit

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

16 Neonatal infection including pneumonia

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

17 Positive neonatal blood culture

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

18 Neonatal necrotising enterocolitis Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.43 [0.07, 2.86]

19 Neonatal respiratory distress syndrome Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.62, 1.49]

20 Treatment with surfactant

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

21 Number of babies requiring ventilation

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

22 Number of babies requiring oxygen therapy

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

23 Neonatal oxygenation > 28 days

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

24 Oxygen treatment > 36 weeks' postconceptual age

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

25 Neonatal encephalopathy

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

26 Neonatal intraventricular haemorrhage Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.33 [0.04, 3.12]

27 Perinatal death/death before discharge Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.40 [0.05, 2.94]

28 Serious childhood disability at 7 years

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 5. 3 versus 7 day ampicillin regimens