ArticleAmerican journal of obstetrics and gynecology2020
Antibiotic administration reduces the rate of intraamniotic inflammation in preterm prelabor rupture of the membranes.
Article in American journal of obstetrics and gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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Who cites it
43 citing papers in PubMed, 98 citations in OpenAlex.
- Agent, Dose and Duration: The Unanswered Questions Behind Latency Antibiotic Therapy for Preterm Prelabour Rupture of Membranes.Antibiotics (Basel, Switzerland) · 2026Review
- Intra-amniotic infection: diagnosis, nomenclature, clinical significance, management, and microbiologic tools used for the diagnosis.Clinical microbiology reviews · 2026Review
- Characteristics, Epigenetics, and Management of Non-Infectious Preterm Birth-Sterile Intrauterine Inflammation and Idiopathic Preterm Birth.Life (Basel, Switzerland) · 2026Review
- Comparative Effectiveness of Azithromycin versus Erythromycin for Latency Prolongation in Preterm Prelabor Rupture of Membranes < 34 Weeks of Gestation.International journal of women's health · 2026Article
- Article
- Co-trimoxazole-induced reproductive toxicity and placental-barrier disruption: impact on cell-cell junctions and ERK signaling pathway.Frontiers in cell and developmental biology · 2026Article
- Systemic immune-inflammation index predicts acute histologic chorioamnionitis pathologic staging and neonatal respiratory distress syndrome in women with preterm premature rupture of membranes: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Article
- Quantification of intra-amniotic inflammation in late preterm prelabour rupture of membranes.Scientific reports · 2025Article
- IL-1β stimulates ADAMTS9 expression and contributes to preterm prelabor rupture of membranes.Cell communication and signaling : CCS · 2025Article
- Changes in vaginal Ureaplasma and Lactobacillus due to antibiotic regimen for premature rupture of membranes.PloS one · 2025Article
- Plasma acute phase proteins as potential predictors of intra-amniotic inflammation and infection in preterm premature rupture of membranes.Innate immunity · 2024Article
- Quantitative cervicovaginal fluid fetal fibronectin: A liquid biopsy for intra-amniotic inflammation.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Successful eradication of group B Streptococcus intraamniotic infection with antibiotics in preterm prelabor rupture of the membranes.American journal of obstetrics and gynecology · 2024Article
- High-Throughput 3D-Printed Model of the Feto-Maternal Interface for the Discovery and Development of Preterm Birth Therapies.ACS applied materials & interfaces · 2024Article
- Angiogenic imbalance in pregnancies with preterm prelabor rupture of membranes between 34 and 37 weeks of gestation.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment.American journal of obstetrics and gynecology · 2024Review
- Blockade of IL-6R prevents preterm birth and adverse neonatal outcomes.EBioMedicine · 2023Article
- A key role for NLRP3 signaling in preterm labor and birth driven by the alarmin S100B.Translational research : the journal of laboratory and clinical medicine · 2023Article
- Article
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Authors and funding
14 authors at 3 institutions in 4 countries.
Funding
Abstract
backgroundPreterm prelabor rupture of the membranes (PPROM) is frequently complicated by intraamniotic inflammatory processes such as intraamniotic infection and sterile intraamniotic inflammation. Antibiotic therapy is recommended to patients with PPROM to prolong the interval between this complication and delivery (latency period), reduce the risk of clinical chorioamnionitis, and improve neonatal outcome. However, there is a lack of information regarding whether the administration of antibiotics can reduce the intensity of the intraamniotic inflammatory response or eradicate microorganisms in patients with PPROM.
objectiveThe first aim of the study was to determine whether antimicrobial agents can reduce the magnitude of the intraamniotic inflammatory response in patients with PPROM by assessing the concentrations of interleukin-6 in amniotic fluid before and after antibiotic treatment. The second aim was to determine whether treatment with intravenous clarithromycin changes the microbial load of Ureaplasma spp DNA in amniotic fluid. STUDY
designA retrospective cohort study included patients who had (1) a singleton gestation, (2) PPROM between 24+0 and 33+6 weeks, (3) a transabdominal amniocentesis at the time of admission, and (4) intravenous antibiotic treatment (clarithromycin for patients with intraamniotic inflammation and benzylpenicillin/clindamycin in the cases of allergy in patients without intraamniotic inflammation) for 7 days. Follow-up amniocenteses (7
resultsA total of 270 patients with PPROM were included in this study: 207 patients delivered within 7 days and 63 patients delivered after 7 days of admission. Of the 63 patients who delivered after 7 days following the initial amniocentesis, 40 underwent a follow-up amniocentesis. Patients with intraamniotic infection (n = 7) and sterile intraamniotic inflammation (n = 7) were treated with intravenous clarithromycin. Patients without either microbial invasion of the amniotic cavity or intraamniotic inflammation (n = 26) were treated with benzylpenicillin or clindamycin. Treatment with clarithromycin decreased the interleukin-6 concentration in amniotic fluid at the follow-up amniocentesis compared to the initial amniocentesis in patients with intraamniotic infection (follow-up: median, 295 pg/mL, interquartile range [IQR], 72-673 vs initial: median, 2973 pg/mL, IQR, 1750-6296; P = .02) and in those with sterile intraamniotic inflammation (follow-up: median, 221 pg/mL, IQR 118-366 pg/mL vs initial: median, 1446 pg/mL, IQR, 1300-2941; P = .02). Samples of amniotic fluid with Ureaplasma spp DNA had a lower microbial load at the time of follow-up amniocentesis compared to the initial amniocentesis (follow-up: median, 1.8 × 10
conclusionIntravenous therapy with clarithromycin was associated with a reduction in the intensity of the intraamniotic inflammatory response in patients with PPROM with either intraamniotic infection or sterile intraamniotic inflammation. Moreover, treatment with clarithromycin was related to a reduction in the load of Ureaplasma spp DNA in the amniotic fluid of patients with PPROM <34 weeks of gestation.
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