Short-Term Outcomes of Expectant Management With Antibiotics for Preterm Subclinical Intra-Amniotic Infection

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Microbiology

Background:

• Intra-amniotic infection (IAI) poses risks during pregnancy.
• Effective management strategies for IAI, particularly those caused by specific microorganisms, require further investigation.

Purpose of the Study:

• To assess the efficacy of expectant management with antibiotics for intra-amniotic infections.
• To evaluate pregnancy prolongation and inflammation exacerbation in patients with IAI.

Main Methods:

• Retrospective cohort study of singleton pregnant women with IAI (20-33 weeks gestation).
• IAI diagnosis based on amniotic fluid interleukin-6 levels (≥3.0 ng/mL) and positive cultures.
• First-line treatment included sulbactam/ampicillin and azithromycin.

Main Results:

• Pregnancy prolonged beyond 48 hours without exacerbation in 71.9% of the Ureaplasma spp./Mycoplasma hominis-only group vs. 23.0% in the other bacterial group (p=0.006).
• Pregnancy prolonged beyond 168 hours occurred in 28.1% of the Ureaplasma spp./Mycoplasma hominis-only group vs. 0% in the other bacterial group (p=0.04).

Conclusions:

• Expectant management with antibiotics is a feasible short-term strategy for subclinical IAI caused solely by Ureaplasma spp./Mycoplasma hominis.
• Optimal management strategies for IAI caused by other bacteria require further investigation.