ArticleBJOG : an international journal of obstetrics and gynaecology2022
Antibiotic prophylaxis in preterm premature rupture of membranes at 24-31 weeks' gestation: Perinatal and 2-year outcomes in the EPIPAGE-2 cohort.
Article in BJOG : an international journal of obstetrics and gynaecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Prevalence and bacteriological profile of pathogens causing neonatal sepsis in Tanzania: a systematic review with meta-analysis.BMC pediatrics · 2026Pooled it
- Identifying Priority Outcomes for Mothers and Babies in Pregnancies With Preterm Pre-Labour Rupture of Membranes for Future Clinical Trials.The Australian & New Zealand journal of obstetrics & gynaecology · 2026Article
- Perinatal Antibiotic Timing Impairs Maternal IgG Transfer via FcRn and Shapes the Neonatal Gut Microbiome in Mice.Microorganisms · 2026Article
- Prevalence and risk factors for neonatal sepsis among very preterm infants in China: a systematic review and meta-analysis.Frontiers in pediatrics · 2026Review
- Clinician's Approach to Antibiotic Treatment and Management of Preterm Prelabour Rupture of Membranes (PPROM) in Australia and Aotearoa New Zealand-A Survey.The Australian & New Zealand journal of obstetrics & gynaecology · 2025Article
- Do we need to reconsider our antibiotic regimen for preterm premature rupture of membranes? Pathogens and perinatal outcome in PPROM.BMC pregnancy and childbirth · 2025Article
- Natural History of Preterm Pre-labour Rupture of Membranes in a Singleton Primipara in a Rural Low-Resource Setting in the Absence of Early Antibiotic Intervention: a Case Report.CME journal of clinical case reports · 2025Article
- The Management of Pregnancy Complicated with the Previable Preterm and Preterm Premature Rupture of the Membranes: What about a Limit of Neonatal Viability?-A Review.Diagnostics (Basel, Switzerland) · 2022Review
- Antibiotic prophylaxis in preterm premature rupture of membranes at 24-31 weeks' gestation: Perinatal and 2-year outcomes in the EPIPAGE-2 cohort.BJOG : an international journal of obstetrics and gynaecology · 2022Article
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveTo compare different antibiotic prophylaxis administered after preterm premature rupture of membranes to determine whether any were associated with differences in obstetric and/or neonatal outcomes and/or neurodevelopmental outcomes at 2 years of corrected age.
designProspective, nationwide, population-based EPIPAGE-2 cohort study of preterm infants.
settingFrance, 2011. SAMPLE: We included 492 women with a singleton pregnancy and a diagnosis of preterm premature rupture of membranes at 24-31 weeks. Exclusion criteria were contraindication to expectant management or indication for antibiotic therapy other than preterm premature rupture of membranes. Antibiotic prophylaxis was categorised as amoxicillin (n = 345), macrolide (n = 30), third-generation cephalosporin (n = 45) or any combinations covering Streptococcus agalactiae and >90% of Escherichia coli (n = 72), initiated within 24 hours after preterm premature rupture of membranes.
methodsPopulation-averaged robust Poisson models.
main outcome measuresSurvival at discharge without severe neonatal morbidity, 2-year neurodevelopment.
resultsWith amoxicillin, macrolide, third-generation cephalosporin and combinations, 78.5%, 83.9%, 93.6% and 86.0% of neonates were discharged alive without severe morbidity. The administration of third-generation cephalosporin or any E. coli-targeting combinations was associated with improved survival without severe morbidity (adjusted risk ratio 1.25 [95% confidence interval 1.08-1.45] and 1.10 [95 % confidence interval 1.01-1.20], respectively) compared with amoxicillin. We evidenced no increase in neonatal sepsis related to third-generation cephalosporin-resistant pathogen.
conclusionIn preterm premature rupture of membranes at 24-31 weeks, antibiotic prophylaxis based on third-generation cephalosporin may be associated with improved survival without severe neonatal morbidity when compared with amoxicillin, with no evidence of increase in neonatal sepsis related to third-generation cephalosporin-resistant pathogen. TWEETABLE ABSTRACT: Antibiotic prophylaxis after PPROM at 24-31 weeks: 3rd-generation cephalosporins associated with improved neonatal outcomes.
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