A secondary analysis of the WHO Global Survey on Maternal and Perinatal Health for antibiotics used in vaginal deliveries

ObjectiveTo assess the rate of antibiotic administration following vaginal delivery and to determine whether maternal characteristics and healthcare system features affected antibiotic use during or immediately after delivery using data from the WHO Global Survey on Maternal and Perinatal Health in Latin America, Africa, and Asia.MethodsThe study included women who delivered vaginally without any obvious infection, diabetes, HIV, cardiorenal or respiratory disease, urinary tract infection, or rupture of membranes. The proportion of women receiving antibiotics within and across regions was determined and associated factors of prophylactic use were analyzed using generalized linear mixed models.ResultsOf the 171 676 women giving birth vaginally, 47.3% received antibiotics, with half of these women receiving antibiotics during and/or immediately after delivery for prophylaxis. Among 131 554 women given prophylactic or no antibiotics, 31.2% received prophylactic antibiotics but the rate varied among regions. Women with an operative vaginal delivery (compared with those who delivered spontaneously) and women with third- or fourth-degree laceration were more likely to receive prophylactic antibiotics.ConclusionAntibiotic use following vaginal delivery varies widely across geographic regions; however, approximately one-third of women undergoing vaginal delivery without documented indication for antibiotic administration appear to have received antibiotics.