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作 者:Alan T N Tita
机构地区:[1]不详
出 处:《四川生理科学杂志》2023年第2期370-370,共1页Sichuan Journal of Physiological Sciences
摘 要:Background: The use of azithromycin reduces maternal infection in women during planned cesarean delivery, but its effecton those with planned vaginal delivery is unknown. Data are needed on whether an intrapartum oral dose of azithromycin wouldreduce maternal and offspring sepsis or death.Methods: In this multicountry, placebo-controlled, randomized trial, we assigned women who were in labor at 28 weeks'gestation or more and who were planning a vaginal delivery to receive a single 2-g oral dose of azithromycin or placebo. The twoprimary outcomes were a composite of maternal sepsis or death and a composite of stillbirth or neonatal death or sepsis. Duringan interim analysis, the data and safety monitoring committee recommended stopping the trial for maternal benefit.Results: A total of 29,278 women underwent randomization. The incidence of maternal sepsis or death was lower in theazithromycin group than in the placebo group (1.6% vs. 2.4%), with a relative risk of 0.67 (95% confidence interval [CI], 0.56 to0.79;P<0.001), but the incidence of stillbirth or neonatal death or sepsis was similar (10.5% vs. 10.3%), with a relative risk of1.02 (95% CI, 0.95 to 1.09;P = 0.56). The difference in the maternal primary outcome appeared to be driven mainly by theincidence of sepsis (1.5% in the azithromycin group and 2.3% in the placebo group), with a relative risk of 0.65 (95% CI, 0.55 to0.77);the incidence of death from any cause was 0.1% in the two groups (relative risk, 1.23;95% CI, 0.51 to 2.97). Neonatalsepsis occurred in 9.8% and 9.6% of the infants, respectively (relative risk, 1.03;95% CI, 0.96 to 1.10). The incidence of stillbirthwas 0.4% in the two groups (relative risk, 1.06;95% CI, 0.74 to 1.53);neonatal death within 4 weeks after birth occurred in 1.5%in both groups (relative risk, 1.03;95% CI, 0.86 to 1.24). Azithromycin was not associated with a higher incidence in adverseevents.Conclusions: Among women planning a vaginal delivery, a single oral dose of azithromycin resulted in a significantly lowerrisk of mat
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