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Cochrane Database of Systematic Reviews

Antibióticos para el líquido amniótico teñido con meconio en el trabajo de parto para la prevención de las infecciones maternas y neonatales

Información

DOI:
https://doi.org/10.1002/14651858.CD007772.pub3Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 06 noviembre 2014see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Embarazo y parto

Copyright:
  1. Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Contraer

Autores

  • Thitiporn Siriwachirachai

    Correspondencia a: Department of Obstetrics and Gynaecology, Khon Kaen Hospital, Khon Kaen, Thailand

    [email protected]

    [email protected]

  • Ussanee S Sangkomkamhang

    Department of Obstetrics and Gynaecology, Khon Kaen Hospital, Khon Kaen, Thailand

  • Pisake Lumbiganon

    Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

  • Malinee Laopaiboon

    Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand

Contributions of authors

Thitiporn Siriwachirachai and Ussanee Sangkomkamhang drafted the review, Pisake Lumbiganon and Malinee Laopaiboon revised and approved the final version of the review.

Sources of support

Internal sources

  • Khon Kaen Hospital, Ministry of Public Health, Thailand.

  • Faculty of Medicine, Khon Kaen University, Thailand.

  • Faculty of Public Health, Khon Kaen University, Thailand.

External sources

  • Thailand Research Fund, Senior Research Scholar, Thailand.

  • Thai Cochrane Network, Thailand.

  • UNDP‐UNFPA‐UNICEF‐WHO‐World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), World Health Organization, Switzerland.

Declarations of interest

None known.

Acknowledgements

As part of the pre‐publication editorial process, this review has been commented on by two peers (an editor and referee who is external to the editorial team), a member of the Pregnancy and Childbirth Group's international panel of consumers and the Group's Statistical Adviser. We thank Erika Ota and Nancy Medley for help in preparing the 'Summary of findings' table.

Erika Ota and Nancy Medley's work was financially supported by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), World Health Organization. The named authors alone are responsible for the views expressed in this publication.

Version history

Published

Title

Stage

Authors

Version

2014 Nov 06

Antibiotics for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections

Review

Thitiporn Siriwachirachai, Ussanee S Sangkomkamhang, Pisake Lumbiganon, Malinee Laopaiboon

https://doi.org/10.1002/14651858.CD007772.pub3

2010 Dec 08

Antibiotics for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections

Review

Thitiporn Siriwachirachai, Ussanee S Sangkomkamhang, Pisake Lumbiganon, Malinee Laopaiboon

https://doi.org/10.1002/14651858.CD007772.pub2

2009 Apr 15

Antibiotics for meconium‐stained amniotic fluid in labour for preventing neonatal sepsis

Protocol

Thitiporn Siriwachirachai, Ussanee S Sangkomkamhang, Pisake Lumbiganon, Malinee Laopaiboon

https://doi.org/10.1002/14651858.CD007772

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Female; Humans; Infant, Newborn; Pregnancy;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

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

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Comparison 1 Antibiotic versus placebo, Outcome 1 Neonatal sepsis.
Figuras y tablas -
Analysis 1.1

Comparison 1 Antibiotic versus placebo, Outcome 1 Neonatal sepsis.

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Comparison 1 Antibiotic versus placebo, Outcome 2 Chorioamnionitis.
Figuras y tablas -
Analysis 1.2

Comparison 1 Antibiotic versus placebo, Outcome 2 Chorioamnionitis.

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Comparison 1 Antibiotic versus placebo, Outcome 3 Postpartum endometritis.
Figuras y tablas -
Analysis 1.3

Comparison 1 Antibiotic versus placebo, Outcome 3 Postpartum endometritis.

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Comparison 1 Antibiotic versus placebo, Outcome 4 Neonatal intensive care admissions.
Figuras y tablas -
Analysis 1.4

Comparison 1 Antibiotic versus placebo, Outcome 4 Neonatal intensive care admissions.

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Summary of findings for the main comparison. Antibiotic versus placebo for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections

Antibiotic versus placebo for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections

Population: Women with meconium‐stained amniotic fluid in labour, gestational age more than 24 weeks
Settings: A hospital, North Carolina, United States
Intervention: Antibiotic versus placebo for preventing maternal and neonatal infections

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Antibiotic versus placebo

Neonatal sepsis

Study population

RR 1
(0.21 to 4.76)

120
(1 study)

⊕⊕⊝⊝
low1

50 per 1000

50 per 1000
(10 to 238)

Moderate

50 per 1000

50 per 1000
(10 to 238)

Chorioamnionitis

Study population

RR 0.36
(0.21 to 0.62)

362
(2 studies)

⊕⊕⊕⊝
moderate2

240 per 1000

86 per 1000
(50 to 149)

Moderate

239 per 1000

86 per 1000
(50 to 148)

Postpartum endometritis

Study population

RR 0.5
(0.18 to 1.38)

120
(1 study)

⊕⊕⊝⊝
low1

167 per 1000

83 per 1000
(30 to 230)

Moderate

167 per 1000

84 per 1000
(30 to 230)

Mortality and morbidity prior to discharge (Neonatal intensive care admissions)

Study population

RR 0.83
(0.39 to 1.78)

120
(1 study)

⊕⊕⊝⊝
low1

200 per 1000

166 per 1000
(78 to 356)

Moderate

200 per 1000

166 per 1000
(78 to 356)

Side effects of treatment

Not estimable

0 (0 study)

See comment

This outcome was not reported in any of the included studies.

Duration of admission to neonatal intensive care unit

Not estimable

0 (0 study)

See comment

This outcome was not reported in any of the included studies.

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Wide confidence interval crossing the line of no effect, small sample size and few events (‐2).
2 Most weight contributed by a study with design limitations (‐1).

Figuras y tablas -
Summary of findings for the main comparison. Antibiotic versus placebo for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections
Ir a la tabla de la revisión
Comparison 1. Antibiotic versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Neonatal sepsis Show forest plot

1

120

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.21, 4.76]

2 Chorioamnionitis Show forest plot

2

362

Risk Ratio (M‐H, Fixed, 95% CI)

0.36 [0.21, 0.62]

3 Postpartum endometritis Show forest plot

1

120

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.18, 1.38]

4 Neonatal intensive care admissions Show forest plot

1

120

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.39, 1.78]
Figuras y tablas -
Comparison 1. Antibiotic versus placebo
Ir a la tabla de la revisión