Abstract：
OBJECTIVE: To investigate the efficacy of vaginal probiotics administration in combination with prophylactic antibiotics versus antibiotic prophylaxis only on perinatal outcomes in women with preterm premature rupture of membrane (PPROM).
METHODS: Four different databases were searched from inception till March 2023. We selected randomized controlled trials (RCTs) that compared vaginal probiotics along with antibiotics versus antibiotics only among pregnant women who were presented with PPROM between 24 and 34 weeks of gestation. We performed the meta-analysis using Revman software. Our primary outcomes were gestational age at birth and latency period duration. Our secondary outcomes were the rate of admission in the neonatal intensive care unit (NICU), infant birth weight, length of stay in the NICU, and neonatal complications.
RESULTS: Four RCTs, involving a total of 339 patients, were included in the meta-analysis. The gestational age at the time of delivery and latency period duration were significantly higher among probiotics + antibiotics group (p = 0.01 & p < 0.001). There was a significant reduction in the rate of NICU admission and length of NICU stay among the probiotics + antibiotics group compared to the antibiotics only group. A significant improvement in the infant birth weight after delivery was demonstrated among the probiotics + antibiotics group (p = 0.002). Although there was a decrease in the incidence of neonatal sepsis and respiratory distress syndrome within probiotics + antibiotics group versus antibiotics only group, these differences were not statistically significant (p > 0.05).
CONCLUSIONS: The combination of vaginal probiotics and antibiotic prophylaxis has been shown to effectively improve perinatal outcomes in women with PPROM. Further trials are needed to validate our findings.
METHODS: Four different databases were searched from inception till March 2023. We selected randomized controlled trials (RCTs) that compared vaginal probiotics along with antibiotics versus antibiotics only among pregnant women who were presented with PPROM between 24 and 34 weeks of gestation. We performed the meta-analysis using Revman software. Our primary outcomes were gestational age at birth and latency period duration. Our secondary outcomes were the rate of admission in the neonatal intensive care unit (NICU), infant birth weight, length of stay in the NICU, and neonatal complications.
RESULTS: Four RCTs, involving a total of 339 patients, were included in the meta-analysis. The gestational age at the time of delivery and latency period duration were significantly higher among probiotics + antibiotics group (p = 0.01 & p < 0.001). There was a significant reduction in the rate of NICU admission and length of NICU stay among the probiotics + antibiotics group compared to the antibiotics only group. A significant improvement in the infant birth weight after delivery was demonstrated among the probiotics + antibiotics group (p = 0.002). Although there was a decrease in the incidence of neonatal sepsis and respiratory distress syndrome within probiotics + antibiotics group versus antibiotics only group, these differences were not statistically significant (p > 0.05).
CONCLUSIONS: The combination of vaginal probiotics and antibiotic prophylaxis has been shown to effectively improve perinatal outcomes in women with PPROM. Further trials are needed to validate our findings.
摘要：
目的：探讨阴道益生菌联合预防性抗生素与仅预防性抗生素对早产胎膜早破（PPROM）妇女围产期结局的影响。
方法：从开始到2023年3月搜索了四个不同的数据库。我们选择了随机对照试验（RCT），该试验仅在妊娠24至34周出现PPROM的孕妇中比较了阴道益生菌和抗生素与抗生素。我们使用Revman软件进行荟萃分析。我们的主要结果是出生时的胎龄和潜伏期持续时间。我们的次要结果是新生儿重症监护病房（NICU）的入院率，婴儿出生体重,在NICU的停留时间,和新生儿并发症。
结果：四个RCT，共涉及339名患者，纳入荟萃分析。在益生菌+抗生素组中,分娩时的胎龄和潜伏期持续时间显著较高(p=0.01和p<0.001)。与仅抗生素组相比，益生菌+抗生素组的NICU入院率和NICU停留时间显着降低。在益生菌+抗生素组中，分娩后婴儿出生体重显着改善（p=0.002）。尽管益生菌+抗生素组和仅抗生素组新生儿败血症和呼吸窘迫综合征的发病率有所下降，差异无统计学意义(p>0.05)。
结论：已显示，阴道益生菌和抗生素预防的组合可有效改善PPROM妇女的围产期结局。需要进一步的试验来验证我们的发现。
方法：从开始到2023年3月搜索了四个不同的数据库。我们选择了随机对照试验（RCT），该试验仅在妊娠24至34周出现PPROM的孕妇中比较了阴道益生菌和抗生素与抗生素。我们使用Revman软件进行荟萃分析。我们的主要结果是出生时的胎龄和潜伏期持续时间。我们的次要结果是新生儿重症监护病房（NICU）的入院率，婴儿出生体重,在NICU的停留时间,和新生儿并发症。
结果：四个RCT，共涉及339名患者，纳入荟萃分析。在益生菌+抗生素组中,分娩时的胎龄和潜伏期持续时间显著较高(p=0.01和p<0.001)。与仅抗生素组相比，益生菌+抗生素组的NICU入院率和NICU停留时间显着降低。在益生菌+抗生素组中，分娩后婴儿出生体重显着改善（p=0.002）。尽管益生菌+抗生素组和仅抗生素组新生儿败血症和呼吸窘迫综合征的发病率有所下降，差异无统计学意义(p>0.05)。
结论：已显示，阴道益生菌和抗生素预防的组合可有效改善PPROM妇女的围产期结局。需要进一步的试验来验证我们的发现。
