Summary of findings for the main comparison. Prophylactic antibiotics versus placebo for preventing infectious morbidity and mortality.
| Prophylactic antibiotics versus placebo for preventing infectious morbidity and mortality | ||||||
| Population: women in the second or third trimester of pregnancy before labour and delivery Settings: hospitals in Kenya, Belgium, USA, India, The Netherlands Intervention: prophylactic antibiotics versus placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Prophylactic antibiotics versus placebo | |||||
| Preterm prelabour rupture of membranes | Study population | RR 0.31 (0.06 to 1.49) | 229 (1 study) | ⊕⊕⊝⊝ low1,2 | ||
| 84 per 1000 | 60 per 1000 (16 to 224) | |||||
| Moderate | ||||||
| 55 per 1000 | 40 per 1000 (10 to 147) | |||||
| Prelabour rupture of membranes | Study population | RR 0.34 (0.15 to 0.78) | 229 (1 study) | ⊕⊕⊝⊝ low2,3 | ||
| 173 per 1000 | 59 per 1000 (26 to 135) | |||||
| Moderate | ||||||
| 173 per 1000 | 59 per 1000 (26 to 135) | |||||
| Preterm delivery | Study population | RR 0.88 (0.72 to 1.09) | 3663 (6 studies) | ⊕⊕⊕⊕ high | ||
| 155 per 1000 | 150 per 1000 (127 to 178) | |||||
| Moderate | ||||||
| 101 per 1000 | 98 per 1000 (83 to 116) | |||||
| Chorioamnionitis | Study population | RR 0.62 (0.10 to 3.62) | 229 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | ||
| 27 per 1000 | 17 per 1000 (3 to 99) | |||||
| Moderate | ||||||
| 27 per 1000 | 17 per 1000 (3 to 98) | |||||
| Puerperal sepsis/postpartum endometritis | Study population | RR 0.53 (0.35 to 0.82) | 627 (3 studies) | ⊕⊕⊕⊝ moderate4 | ||
| 161 per 1000 | 85 per 1000 (56 to 132) | |||||
| Moderate | ||||||
| 104 per 1000 | 55 per 1000 (36 to 85) | |||||
| Intrapartum fever needing treatment with antibiotics | Not estimable | (0 study) | See comment | This outcome was not reported in any of the included studies. | ||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in the footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Wide confidence interval crossing the line of no effect, few events & small sample size. 2 One study with design limitations. 3 Few events and small sample size. 4 Small sample size.