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Study Questions Antibiotics' Safety in Preterm Labor

There's important new information out today for pregnant women and their doctors: Giving antibiotics to some pregnant women who have gone into labor too early could be dangerous for the long-term development of their children, according to a major new study.

Now, it's important to make it clear right away that if a pregnant woman definitely has an infection she should take an antibiotic--an infection can be very dangerous to the mom and baby. But the new study says doctors should be very careful about giving a pregnant woman antibiotics if there is no clear evidence that she has an infection and her water hasn't broken.

This comes from a big international study involving more than 11,000 women known as the ORACLE study. British researchers started it to find out if antibiotics might help women who go into labor too soon. Infections can trigger premature labor without causing any other symptoms. So the idea was that antibiotics could help.

In 2001, the researchers reported that giving erythromycin to pregnant women whose water had broken prematurely reduced the risk their babies would develop infections, breathing problems and other short-term complications. But erythromycin didn't seem to help women in premature labor whose water had not broken.

The researchers then followed more than 6,000 of the children in the study who were born in England to see how they fared. In a pair of papers released yesterday by the journal The Lancet, the researchers reported that those whose mothers took erythromycin before their water broke were 18 percent more likely to have mild developmental problems. And, perhaps most disturbing, they were about three times as likely to have cerebral palsy.

The researchers do not know why antibiotics would cause those problems, but they speculate that perhaps keeping a fetus in the womb of a mother who has an infection may not be good for the child.

Now, it's important to note that current guidelines only recommend antibiotics for pregnant women whose water has broken or have clear signs of an infection, and the study shows that is the right thing to do.

But experts say it's important to get the word out in case some doctors are giving pregnant women who go into premature labor antibiotics even though their water has not broken and they have no obvious signs of infection.

The research also is a good reminder that just because something seems like a good idea you never know for sure until you do the research to find out. You could end up doing more harm than good.

By Rob Stein  |  September 18, 2008; 7:00 AM ET
Categories:  Cancer , Motherhood  
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