Routine antibiotics for preterm labour: risk of cerebral palsy.

Epidemiological studies have suggested a link between maternal infection and preterm delivery. In 2001, however, the Oracle II trial, including about 6000 pregnant women, showed that routine antibiotic administration (erythromycin or amoxicillin + clavulanic acid) in cases of spontaneous preterm labour without membrane rupture or clear signs of infection had no immediate benefits for the newborn child. A systematic review subsequently confirmed this finding. In 2008, follow-up of 3196 of the children born to mothers enrolled in this study, up to the age of 7 years, showed a statistically significant increase in cerebral palsy among children whose mothers had received erythromycin or amoxicillin + clavulanic acid. In practice, antibiotics should not be routinely prescribed to women with preterm labour but without membrane rupture or signs of infection, due to an increased risk of cerebral palsy. The probable benefits outweigh the risks when a significant bacterial infection is diagnosed.