Study Objective: To assess the efficiency of antibacterial therapy in women with intrauterine infections (IUI) in the second trimester of pregnancy in order to prevent premature delivery.
Study Design: retrospective and prospective comparative study.
Materials and Methods. The study enrolled 112 pregnant women with asymptomatic IUI divided into two groups. The treatment group included 52 pregnant women with IUI, who were treated with antibacterials in the second trimester of pregnancy. The comparison group (historical control) was formed based on the retrospective analysis of 5,115 labour and delivery records (continuous sampling). We selected 60 women with IUI who were not treated with antibacterials during pregnancy.
Study Results. Systemic antibiotic therapy during pregnancy in women with IUI results in more than 2-fold reduction in the risk of premature delivery (RR = 2.29, NNT = 2.6, p < 0.0001), while the risk of extremely premature delivery is reduced 12-fold (RR = 12.1, NNT = 4.7, p < 0.0001). Analysis of pathologies in babies born by the studied women demonstrated that in the therapy group an intrauterine infection was diagnosed in 11.5%, whereas in the comparison group one out of three babies had an infection (33.3%) (pχ2 = 0.007). Intrauterine growth retardation at birth was significantly more rare in babies born by the women from the therapy group (17.3%) vs. the historical control group (41.7%; pχ2 = 0.007). Cerebral ischemia was diagnosed in 21.2% of newborns from the treatment group and in 53.3% of newborns from the comparison group (pχ2 < 0.0001). Respiratory distress syndrome was recorded in 15.4% and 56.7% of newborns in the treatment and comparison group, respectively (pχ2 < 0.0001). In the comparison group, there were 6 (10%) cases of early neonatal deaths, whereas no deaths occurred in the treatment group (рF = 0.029).
Conclusion. The study confirms the justified system antibacterial therapy in women with asymptomatic IUI. Timely prescription of the system antibacterial therapy in patients with IUI improves perinatal outcomes.
Contributions: Dolgushina, V.F. and Kurnosenko, I.V. — study concept and design, manuscript editing, approval of the final article version, cohesion of all parts of the article; Astashkina, M.V. — collection and processing of retrospective and prospective materials, statistical data processing, thematic publications reviewing, manuscript preparation; Semenov, Yu.A. — collection and processing of retrospective and prospective materials, manuscript preparation.
Conflict of interest: The authors declare that they do not have any conflict of interests.
I.V. Kurnosenko — South Ural State Medical University of the Ministry of Health of the Russian Federation; 64 Vorovskiy Str., Chelyabinsk, Russian Federation 454092. E-mail: firstname.lastname@example.org
M.V. Astashkina (Corresponding author) — South Ural State Medical University of the Ministry of Health of the Russian Federation; 64 Vorovskiy Str., Chelyabinsk, Russian Federation 454092. https //orcid.org/0000-0003-4756-4500. E-mail: email@example.com
V.F. Dolgushina — South Ural State Medical University of the Ministry of Health of the Russian Federation; 64 Vorovskiy Str., Chelyabinsk, Russian Federation 454092. https://orcid.org/0000-0002-3929-7708. E-mail: firstname.lastname@example.org
Yu.A. Semenov — South Ural State Medical University of the Ministry of Health of the Russian Federation; 64 Vorovskiy Str., Chelyabinsk, Russian Federation 454092. https://orcid.org/0000-0002-4109-714X. E-mail: email@example.com