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‘The Lancet’ has today published online the findings from the ORACLE Children Study, a 7 year follow-up study of a large randomised controlled trial of the use of erythromycin and/or co-amoxiclav in women presenting in premature labour (with or without ruptured membranes).
This study has found a small increase in the number of children reported by their parents as having functional impairment, or cerebral palsy, in women in spontaneous preterm labour with intact membranes who received antibiotics. These findings require further study. It is important to note that these women had no evidence of infection and would not routinely be given antibiotics. The mechanism by which this association occurred is unclear, particularly as there was no increased impairment in those with ruptured membranes who received antibiotics.
Pregnant women should not be concerned about taking antibiotics to treat infections. Antibiotics save lives, and pregnant women with possible or obvious infections must be considered for treatment with antibiotics.
This study confirms existing good clinical practice that women in spontaneous pre-term labour with intact membranes should not routinely be given antibiotics if they have no infection.
Further information:
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The Oracle Children Study publications by S Kenyon et al (external link) - (DOI:10.1016/S0140-6736(08)61202-7 and DOI:10.1016/S0140-6736(08)61203-9)
› ORACLE Children Study website (external link).
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Advice from The Chief Medical Officer (external link).
Royal College advice is also available:
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Royal College of Obstetricians and Gynaecologists (external link)
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Royal College of Paediatrics and Child Health (external link)
