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Antibiotics for asymptomatic bacteriuria in pregnancy
1McMaster University, Department of Pathology and Molecular Medicine, Faculty of Health Sciences, Room 2N16, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5. smaill@mcmaster.ca
The Cochrane Database of Systematic Reviews
|April 20, 2007
Summary
Treating asymptomatic bacteriuria in pregnancy with antibiotics effectively reduces pyelonephritis and low birthweight risks. This intervention is crucial for improving pregnancy outcomes, though study quality warrants cautious interpretation.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases in Pregnancy
- Evidence-Based Medicine
Background:
- Asymptomatic bacteriuria (ASB) affects 2-10% of pregnancies.
- Untreated ASB can lead to acute pyelonephritis in up to 30% of mothers.
- ASB is linked to adverse pregnancy outcomes like low birthweight and preterm delivery.
Purpose of the Study:
- To evaluate the impact of antibiotic treatment for ASB during pregnancy.
- To assess effects on persistent bacteriuria, pyelonephritis development, and risks of low birthweight and preterm delivery.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) from the Cochrane Pregnancy and Childbirth Group's Trials Register.
- Included trials compared antibiotic treatment versus placebo or no treatment for ASB in pregnant women.
- Trial quality was assessed.
Main Results:
- Fourteen studies of generally poor quality were included.
- Antibiotic treatment effectively cleared ASB (RR 0.25, 95% CI 0.14-0.48).
- Reduced incidence of pyelonephritis (RR 0.23, 95% CI 0.13-0.41) and low birthweight (RR 0.66, 95% CI 0.49-0.89) observed; no significant difference in preterm delivery.
Conclusions:
- Antibiotic therapy is effective in reducing pyelonephritis risk during pregnancy.
- The observed reduction in low birthweight aligns with infection's role in adverse outcomes.
- Findings on low birthweight should be interpreted cautiously due to the poor quality of included studies.
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