What we have learned regarding antibiotic therapy for the reduction of infant morbidity after preterm premature rupture of the membranes

Brian M. Mercer, Robert L. Goldenberg, Anita F. Das, Gary R. Thurnau, Robert W. Bendon, Menachem Miodovnik, Risa Ramsey, Yolanda A. Rabello

Research output: Contribution to journalArticle

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Abstract

Preterm premature rupture of the membranes (pPROM) is responsible for approximately one third of the over 450,000 preterm births occurring in the United States annually. In this manuscript, we summarize the outcomes and analyses related to the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network (NICHD-MFMU) network multicenter trial of antibiotics to reduce infant morbidity after pPROM. Based on evident reduction in gestational age dependent and infectious infant morbidity, we provide the rationale for aggressive intravenous and oral, broad spectrum Ampicillin/Amoxicillin, and Erythromycin therapy during conservative management of pPROM before 32 weeks' gestation. We further review the histopathologic correlates to pPROM, to antibiotic treatment, and to perinatal outcome, and discuss the relationships between maternal and neonatal cytokine levels intercellular adhesion molecule, and other clinical and plasma markers regarding perinatal morbidity. The use and limitations of ultrasound and vaginally collected amniotic fluid pulmonary maturity assessment are discussed.

Original languageEnglish (US)
Pages (from-to)217-230
Number of pages14
JournalSeminars in Perinatology
Volume27
Issue number3
DOIs
StatePublished - Jan 1 2003

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Anti-Bacterial Agents
Morbidity
National Institute of Child Health and Human Development (U.S.)
Mothers
Amoxicillin
Premature Birth
Cell Adhesion Molecules
Erythromycin
Amniotic Fluid
Therapeutics
Ampicillin
Gestational Age
Multicenter Studies
Biomarkers
Medicine
Cytokines
Pregnancy
Lung
Preterm Premature Rupture of the Membranes
Conservative Treatment

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Mercer, B. M., Goldenberg, R. L., Das, A. F., Thurnau, G. R., Bendon, R. W., Miodovnik, M., ... Rabello, Y. A. (2003). What we have learned regarding antibiotic therapy for the reduction of infant morbidity after preterm premature rupture of the membranes. Seminars in Perinatology, 27(3), 217-230. https://doi.org/10.1016/S0146-0005(03)00016-8

What we have learned regarding antibiotic therapy for the reduction of infant morbidity after preterm premature rupture of the membranes. / Mercer, Brian M.; Goldenberg, Robert L.; Das, Anita F.; Thurnau, Gary R.; Bendon, Robert W.; Miodovnik, Menachem; Ramsey, Risa; Rabello, Yolanda A.

In: Seminars in Perinatology, Vol. 27, No. 3, 01.01.2003, p. 217-230.

Research output: Contribution to journalArticle

Mercer, Brian M. ; Goldenberg, Robert L. ; Das, Anita F. ; Thurnau, Gary R. ; Bendon, Robert W. ; Miodovnik, Menachem ; Ramsey, Risa ; Rabello, Yolanda A. / What we have learned regarding antibiotic therapy for the reduction of infant morbidity after preterm premature rupture of the membranes. In: Seminars in Perinatology. 2003 ; Vol. 27, No. 3. pp. 217-230.
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