SynthesisBJOG : an international journal of obstetrics and gynaecology2013
Timing of administration of prophylactic antibiotics for caesarean section: a systematic review and meta-analysis.
Synthesis in BJOG : an international journal of obstetrics and gynaecology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04697277 (The Effect of Antibiotic Prophylaxis Timing on Intraoperative Nausea and Vomiting in Patients Undergoing Cesarean Section Under Regional Anesthesia.), which is not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Antibiotic Prophylaxis Timing on Intraoperative Nausea and Vomiting in Patients Undergoing Cesarean Section Under Regional Anesthesia.
Who cites it
32 citing papers in PubMed, 5 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Effect of adjunctive prophylactic macrolides used at the caesarean section on endometritis and surgical site wound infection: A meta-analysis.International wound journal · 2023Pooled it
- Pooled it
- Antibiotic regimens for management of intra-amniotic infection.The Cochrane database of systematic reviews · 2014Pooled it
- Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery.The Cochrane database of systematic reviews · 2014Pooled it
- Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section.The Cochrane database of systematic reviews · 2014Pooled it
- Maternal antibiotic prophylaxis during cesarean section has a limited impact on the infant gut microbiome.Cell host & microbe · 2024Trial
- The Impact of Platelet-Rich Plasma Application during Cesarean Section on Wound Healing and Postoperative Pain: A Single-Blind Placebo-Controlled Intervention Study.Medicina (Kaunas, Lithuania) · 2024Trial
- Timing of Adjunctive Azithromycin for Unscheduled Cesarean Delivery and Postdelivery Infection.Obstetrics and gynecology · 2022Trial
- A randomized controlled double blind trial comparing the effects of the prophylactic antibiotic, Cefazolin, administered at caesarean delivery at two different timings (before skin incision and after cord clamping) on both the mother and newborn.BMC pregnancy and childbirth · 2017Trial
- Impact of evidence-based interventions on wound complications after cesarean delivery.American journal of obstetrics and gynecology · 2017Trial
- Perinatal pharmacokinetics of azithromycin for cesarean prophylaxis.American journal of obstetrics and gynecology · 2015Trial
- Antibiotic prophylaxis for caesarean section at a Ugandan hospital: a randomised clinical trial evaluating the effect of administration time on the incidence of postoperative infections.BMC pregnancy and childbirth · 2015Trial
- Timing of Antibiotic Prophylaxis in Elective Caesarean Delivery: A Multi-Center Randomized Controlled Trial and Meta-Analysis.PloS one · 2015Trial
- Cesarean delivery volume and risk of long-term neurodevelopmental disorders in offspring.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Antimicrobial Prescribing Practices for Surgical Prophylaxis in Caesarean Sections at Kawempe National Referral Hospital, Kampala, Uganda.Health science reports · 2026Article
- Drawbacks of antibiotic regimen following cesarean deliveries on beneficial bacteria in colostrum, a prospective observational study.BMC nutrition · 2025Article
- Cultured Bacteria in the Abdominal Wall Incision During the Realisation of Caesarean Section in Cows: A Preliminary Study.Veterinary sciences · 2025Article
- Influence of different timeframes of antibiotic application on postoperative infections in patients with caesarean section.Frontiers in surgery · 2025Article
- Bacterial Contamination of the Surgical Site at the Time of Elective Caesarean Section in Belgian Blue Cows-Part 1: Identified by Bacterial Culture.Veterinary sciences · 2022Article
- Description of Plasma Penicillin G Concentrations after Intramuscular Injection in Double-Muscled Cows to Optimize the Timing of Antibiotherapy for Caesarean Section.Veterinary sciences · 2021Article
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProphylactic antibiotics reduce infectious morbidity from caesarean section. The timing of their administration, however, is a matter of controversy.
objectivesTo examine maternal and neonatal infectious morbidity in women receiving preoperative prophylaxis compared with those receiving intraoperative administration. SEARCH STRATEGY: Medline, Embase, Current Controlled Trials and Cochrane Central were searched from their inception dates to December 2011. SELECTION CRITERIA: Randomised controlled trials of a single dose of any antibiotic comparing preoperative with intraoperative administration were selected. DATA COLLECTION AND ANALYSIS: Trial characteristics, outcomes and quality measures, based on the Cochrane tool for risk of bias, were independently extracted. The random effect model of DerSimonian and Laird to estimate relative risks (RRs) for maternal and neonatal outcomes was used. MAIN
resultsSix trials met the inclusion criteria, reporting on 2313 women and 2345 newborns. Preoperative administration was associated with a significant 41% reduction in the rate of endometritis compared with intraoperative administration (RR 0.59; 95% confidence interval [95% CI] 0.37-0.94; I2 0%). In the preoperative group, there were nonsignificant reductions in the rates of wound infection (RR 0.71; 95% CI 0.44-1.14; I2 0%), maternal febrile morbidity (RR 0.94; 95% CI 0.46-1.95; I2 0%), neonatal sepsis (RR 0.81; 95% CI 0.47-1.41; I2 0%), neonatal septic work-up (RR 0.93; 95% CI 0.71-1.21; I2 0%) and neonatal intensive-care unit admission (RR 0.92; 95% CI 0.65-1.28; I2 0%). There were nonsignificant increases in the rates of maternal pyelonephritis (RR 1.09; 95% CI 0.49-2.43; I2 0%) and neonatal pneumonia (RR 3.36; 95% CI 0.55-20.47; I2 0%).
conclusionsCompared with intraoperative administration, preoperative antibiotics significantly reduce the rate of endometritis. The lack of neonatal adverse effects should be cautiously interpreted given the limited power of the trials to detect such effects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.