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Neonatal Med > Volume 22(2); 2015 > Article
Neonatal Medicine 2015;22(2):78-83.
DOI: https://doi.org/10.5385/nm.2015.22.2.78    Published online May 29, 2015.
Effect of Prenatal and Postnatal Prophylaxis with Macrolide for Ureaplasma on the Development of Bronchopulmonary Dysplasia in Preterm Infants.
Euiseok Jung, Suyeong Kim, Young Hwa Jung, Juyoung Lee, Seung Han Shin, Chang Won Choi, Ee Kyung Kim, Han Suk Kim, Beyong Il Kim, Jung Hwan Choi
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. choicw@snu.ac.kr
Abstract
PURPOSE
We aimed to evaluate the effects of two different macrolide prophylaxis protocols (prenatal and postnatal) for Ureaplasma on the development of bronchopulmonary dysplasia (BPD).
METHODS
We retrospectively reviewed the medical charts of 121 preterm infants whose birth weights were <1,250 g or gestational ages were <30 postmenstrual weeks. The demographic and clinical characteristics, including the presence of BPD, were compared between a prophylactic group, who received macrolide as prophylaxis prenatally and postnatally according to risk level, and a confirmed treatment group, who received macrolide prenatally and postnatally after detection of Ureaplasma infection.
RESULTS
Seventy-four (61.2%) of 121 preterm infants were included in the prenatal prophylaxis group. No significant differences in demographic characteristics were observed between the prenatal prophylaxis and prenatal confirmed treatment group. The detection rate of Ureaplasma and the frequency of postnatal therapeutic treatment with macrolide were lower in the prenatal prophylaxis group than in the prenatal confirmed treatment group (16.2% vs. 40.4%, P=0.003; 8.1% vs. 48.9%, P< 0.001, respectively). Although no significant differences in the incidence of moderate to severe BPD, the rate of severe BPD was lower in the prenatal prophylaxis group than in prenatal confirmed treatment group (18.9% vs. 40.4%, P=0.010). No significant differences in the incidences of BPD of any level of severity were observed between the postnatal prophylaxis and confirmed treatment groups.
CONCLUSION
Administration of prenatal prophylaxis with macrolide decreased the detection rate of Ureaplasma after birth and was associated with the decrease in the incidence of severe BPD in preterm infants.
Key Words: Bronchopulmonary dysplasia, Ureaplasma, Macrolides, Infants, Premature


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