Effects of Antenatal Azithromycin forUreaplasmaspp. on Neonatal Outcomes

Department of Pediatrics, Hallym University Medical Center, Seoul, Korea Objective: Ureaplasma spp. in the maternal genitourinary tract is increasingly known to cause preterm labor, spontaneous abortion, chorioamnionitis and adverse neonatal outcomes. However, con trover sies still remain regarding whether or not to treat it aggressively. The aim of this study was to evaluate the effects of antenatal azithromycin (AZ) for Ureaplasma urealyticum (UU) infection on neonatal com plications in preterm infants. Methods: Retrospective singlecenter casecontrol study of preterm babies delivered at <32 weeks’ of gestation age (GA) between 2010 and 2014 were conducted. Cases were defined as infants with complete maternal AZ treatment when UU was confirmed and controls were without UU. Cases were matched with controls by birth year, GA, and birth weight. Subgroup analysis according to GA (23 28 weeks’ and 2932 weeks’) were done as well. Results: Of 169 cases identified 51 with untreated or incompletely treated mother, 26 died or trans ferred, and four with incomplete chart were excluded; thus 88 preterm infants were matched to 88 controls. Incidence of bronchopulmonary dysplasia (BPD) and early sepsis were same in both group; however, in very preterm infants between 23 to 28 weeks’ GA, incidence of moderatetosevere BPD was significantly higher in cases (42% vs. 16%, P=0.022) and incidence of sepsis was significantly lower (8% vs. 26%, P=0.033). Conclusion: Maternal UU was associated with moderatetosevere BPD even though AZ treatment was done. Early sepsis was significantly less developed with prenatal antibiotics at ≤28 weeks’ GA. Hence selective antenatal azithromycin therapy of UU is still needed for improving neonatal out comes.