14 trials and 7 837 women were included in a Cochrane review , where the 'ORACLE II 2001' trial (n=6 295) dominates. Meta-analysis shows a reduction in maternal infection with the use of prophylactic antibiotics (RR 0.74, 95% CI 0.63–0.86; 10 trials, n=7371), but fails to demonstrate a benefit for any of the prespecified neonatal outcomes including perinatal mortality (RR 1.22, 95% CI 0.88–1.69; 10 trials, n=7304) where a trend towards a reduction in fetal deaths (RR 0.73, 95% CI 0.43–1.26; 8 trials, n=7080) was outweighed by a stronger trend towards an increase in neonatal deaths in the antibiotic group (RR 1.57, 95% CI 1.03–2.40). Long-term child outcomes to 7 years of age were available for infants in the UK enrolled in the ORACLE II trial. Comparing any antibiotics with placebo, a marginally non-statistically significant increase was shown in any functional impairment (RR 1.10, 95% CI 0.99 to 1.23) and cerebral palsy (CP) (RR 1.82, 95% CI 0.99 to 3.34). In subgroup analysis, CP was statistically significantly increased for infants of women allocated to macrolide and beta-lactam antibiotics combined compared with placebo (RR 2.83, 95% CI 1.02 to 7.88; NNTH 35, 95% CI 333 to 9).