Antibiotics for the prevention of preterm birth
Notice bibliographique
Résumé
We read with great interest the meta-analysis by Simcox et al. in which they concluded that prophylactic antibiotics were of no benefit in the prevention of preterm birth in high-risk women.1 In a similar meta-analysis we published this year, we reported opposite results, but our inclusion and exclusion criteria were different.2 Three criteria could explain, in part, the differences from the current meta-analysis. In our meta-analysis, randomised trials published in languages other than English were included; secondly, studies with more than 5% loss-to-follow-up were excluded as they can give a high rate of non-compliance and selection biases; and, finally, our selection was limited to investigations of patients whose treatment began during the second trimester of pregnancy. Even though inclusion and exclusion criteria can be justified for different reasons, we believe that some criteria should be considered as mandatory. For example, in one of the studies cited by Simcox et al.3 the authors stated that they included 93 patients from the same multicentre study who had already been incorporated in another previously published report.4 The latter report was also subsumed in the current meta-analysis. We believe that including the same patients twice in a meta-analysis is methodologically inappropriate. Each meta-analysis is limited by its own predetermined criteria. Based on our criteria, we found that erythromycin or clindamycin administration in the second trimester was related to a decrease in the rate of preterm birth.2 Moreover, when we looked at the individual effect of metronidazole (by excluding all studies that added erythromycin or clindamycin to metronidazole), we found that its use was associated with an increase in the rate of preterm birth. Therefore, we agree with the authors on the real possibility of harm by metronidazole to women at high risk of preterm delivery. However, we believe that there is enough evidence to suggest that clindamycin should be recommended for the treatment of bacterial vaginosis in pregnancy and has a high chance of preventing preterm delivery if given during the second trimester.5
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».