Evidence map›Paper›PMID 28974203›Full record

Trial reportBMC pregnancy and childbirth2017

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.

Chinta Annie Jyothirmayi, Ajay Halder, Bijesh Yadav, Santosh Thomas Samuel, Anil Kuruvilla, Ruby Jose

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Chinta Annie JyothirmayiDepartment of Neonatology, Christian Medical College, Vellore, India.
Ajay HalderDepartment of Obstetrics and Gynecology Unit IV, Christian Medical College, Vellore, India.
Bijesh YadavDepartment of Biostatistics, Christian Medical College, Vellore, India.
Santosh Thomas SamuelMLL Hospital, Madanapalle, Chittoor, Andhrapradesh, India.
Anil KuruvillaDepartment of Neonatology, Christian Medical College, Vellore, India.
Ruby JoseDepartment of Obstetrics and Gynecology Unit IV, Christian Medical College, Vellore, India. rubyjose1@gmail.com.
Christian Medical College & Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCaesarean delivery (CD) increases the risk of postpartum infection by 5 to 20 fold. Prevention of surgical site infection (SSI) is the goal of antibiotic prophylaxis. This study was carried out to assess the optimum timing for prophylactic antibiotic administration and to assess the amount of the antibiotic crossing the placental barrier.

methodsEligible mothers were recruited, after informed consent, once the decision for CD was made. Each mother received two injections, one prior to skin incision and one after cord clamping, (one being the study drug Cefazolin, and the other, a placebo) based on the randomization code. Demographic, maternal and neonatal monitoring data until discharge from hospital, and at the 6 weeks postpartum visit were collected. Levels of the prophylactic antibiotic were measured from the cord blood in every 8th neonate. The objective of the study was to compare the effects of the prophylactic antibiotic, intravenous Cefazolin 1 g, administered at Caesarean delivery (CD) at two different timings (before skin incision and after cord clamping) on both the mother and newborn. The secondary outcomes that were followed up were the number of maternal and neonatal readmissions. An appropriate test for significance, Fisher's exact test was used to find the association between risk variables and outcome.

resultsThe total numbers of mothers enrolled were 1106, of whom 553 mothers received antibiotic prior to skin incision (pre-incision) and 543 mothers received antibiotic after cord clamping (post-incision). The pre-incision group had significantly less febrile illness (RR = 0.48, 95% CI: 0.29 - 0.80) and SSI (RR = 0.14, 95% CI: 0.04 - 0.53) when compared with the post- incision group. The post-incision group significantly had >7 days hospital stay when compared to the 4-7 days stay of the pre-incision group (p = 0.005).There were no differences in any of the neonatal outcomes. The quantity of the antibiotic in the cord blood was only 2-3%.

conclusionsPre incision prophylactic antibiotic protected the mother from SSI and febrile illness and decreased the hospital stay significantly.

trial registrationThe Clinical Trials Registry India (CTRI) was [ CTRI/2016/03/006710 dated, 04/03/2016].

Indexed as

AdultAnti-Bacterial AgentsAntibiotic ProphylaxisCefazolinCesarean SectionDouble-Blind MethodFemaleFetal BloodHumansInfant, NewbornLength of StayPregnancySurgical Wound InfectionTime FactorsTreatment OutcomeAnti-Bacterial AgentsCefazolinCaesarian deliveryPost-incisionPre-incisionProphylactic antibiotic

Identifiers

PMID28974203
PMCPMC5627463
OpenAlexW2760996743

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.