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Study: Antibiotics After Assisted Birth Reduce Maternal Infections

Delivery guidelines should be updated to reflect these results, the authors write.

May 14, 2019
Ashley P. Taylor

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A single dose of antibiotics given to women undergoing assisted childbirth, in which doctors use forceps or suction to help the mother deliver the baby, nearly halved maternal infections, according to a trial published yesterday (May 13) in The Lancet. 

Currently, without antibiotic use, up to 16 percent of women develop infections after assisted childbirth and, in the US, 13 percent of maternal deaths are the result of infections, the authors write. For women delivering their babies via Cesarean section, prophylactic antibiotics are recommended, and strong evidence supports those guidelines. However, there has been little research about the potential benefits of these preventive antibiotics with assisted childbirth, and guidelines from the World Health Organization (WHO) and other groups do not recommend their use under that circumstance. 

Marian Knight, a professor of maternal and child population health at the University of Oxford, and colleagues set out to do a study on the effects of the treatment in women who undergo assisted childbirth. Between 2016 and 2018, 3,420 participants in 27 obstetric units across the UK participated in the trial and were randomly assigned to receive either a single dose of antibiotics (amoxicillin and clavulanic acid) or a placebo intravenously within six hours after giving birth. Of the women who did not receive antibiotics, 19 percent had confirmed or suspected infections within six weeks of childbirth, compared with 11 percent of women who received prophylactic treatment. 

Based on these findings, the authors conclude that guidelines by the WHO and other groups should be updated to recommend antibiotic treatment for women undergoing assisted childbirth. “This will have a very big impact on women and not just in terms of the infection rate,” Knight tells The Guardian. “Those who received antibiotics were much less likely to have perineal pain, much less likely to have burst stitches, and they had fewer problems feeding their baby as a consequence of that pain.”

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