New Delhi, Sept. 18: Antibiotics do not help women with signs of
premature labour whose waters have not broken, but increase the risk of
cerebral palsy in their children, a study has found.
The 14-country trial — the world’s largest medical study on the use of
antibiotics in premature labour — was led by a team at Leicester University,
the UK, and involved a seven-year follow-up of more than 8,000 children.
It found that the proportion of children with cerebral palsy, a neurological
condition that disrupts physical movements, was higher among women who had
received erythromycin than among those who did not — 3.3 per cent versus 1.7
per cent.
Mothers given an antibiotic called co-amoxiclav also had a higher proportion
of children with cerebral palsy than those who did not get this antibiotic —
3.2 per cent compared with 1.9 per cent.
Doctors and health authorities, however, have stressed that pregnant women
should not feel concerned about taking antibiotics to treat infections.
“Antibiotics must definitely be given when there is an infection,” said Sara
Kenyon, a researcher at Leicester and co-ordinator of the trial.
“Antibiotics save lives, and pregnant women with possible or obvious
infections must be considered for treatment with antibiotics,” the UK
department of health said in a letter circulated to doctors and pharmacists
across the UK this week.
The findings will be relevant to India where there is evidence of irrational
prescription of antibiotics, said a senior doctor in New Delhi.
Medical studies during the 1990s had suggested that prescribing antibiotics
would help women experiencing premature labour either with or without broken
waters. Doctors prescribed antibiotics in the belief that premature labour
was a sign of a silent, invisible infection.
In a 1994-2000 study, Kenyon and her colleagues had shown that in women
whose membranes had ruptured, erythromycin delayed the onset of labour and
reduced the need to assist the babies with breathing as well as their rate
of infection.
The new study published today in The Lancet followed up children from 2001
to 2007. It found that among children of women whose waters had not broken,
there is an apparent increase in the proportion of mild functional problems
— including poor eyesight and difficulty in day-to-day problem-solving — and
cerebral palsy.
The earlier study had revealed no such differences “This study reaffirms
existing guidance and shows the importance of undertaking long-term
follow-up,” Kenyon told The Telegraph.
Sheela Mane of the Federation of Obstetric and Gynaecological Societies of
India said antibiotics should be prescribed to pregnant women only “when
there is obvious infection”.
