Oral betamimetics for maintenance therapy after threatened preterm labour

Jodie M. Dodd, Caroline A. Crowther, Philippa Middleton

Research output: Contribution to journalReview article

25 Citations (Scopus)

Abstract

Background: Some women who have threatened to give birth prematurely, subsequently settle. They may then take oral tocolytic maintenance therapy to prevent preterm birth and to prolong gestation. Objectives: To assess the effects of oral betamimetic maintenance therapy after threatened preterm labour for preventing preterm birth. Search methods: We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 9 November 2012. Selection criteria: Randomised controlled trials comparing oral betamimetic with alternative tocolytic therapy, placebo or no therapy, for maintenance following treatment of threatened preterm labour. Data collection and analysis: Two review authors independently applied the selection criteria and carried out data extraction and quality assessment of studies. Main results: We did not identify any new trials from the updated search so the results remain unchanged as follows. We included 13 randomised controlled trials (RCTs) with a total of 1551 women. We found no differences for admission to the neonatal intensive care unit when betamimetics were compared with placebo (risk ratio (RR) 1.28, 95% confidence interval (CI) 0.68 to 2.41; two RCTs of terbutaline with 2600 women) or with magnesium (RR 0.80, 95% CI 0.43 to 1.46; one RCT of 137 women). The rate of preterm birth (less than 37 weeks) showed no significant difference in six RCTs, four comparing ritodrine with placebo/no treatment and two comparing terbutaline with placebo/no treatment (RR 1.11, 95% CI 0.91 to 1.35; 644 women). We observed no differences between betamimetics and placebo, no treatment or other tocolytics for perinatal mortality and morbidity outcomes. Some adverse effects such as tachycardia were more frequent in the betamimetics groups than the groups allocated to placebo, no treatment or another type of tocolytic. Authors' conclusions: Available evidence does not support the use of oral betamimetics for maintenance therapy after threatened preterm labour.

LanguageEnglish
Article numberCD003927
JournalCochrane Database of Systematic Reviews
Volume2012
Issue number12
DOIs
Publication statusPublished - 12 Dec 2012

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

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title = "Oral betamimetics for maintenance therapy after threatened preterm labour",
abstract = "Background: Some women who have threatened to give birth prematurely, subsequently settle. They may then take oral tocolytic maintenance therapy to prevent preterm birth and to prolong gestation. Objectives: To assess the effects of oral betamimetic maintenance therapy after threatened preterm labour for preventing preterm birth. Search methods: We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 9 November 2012. Selection criteria: Randomised controlled trials comparing oral betamimetic with alternative tocolytic therapy, placebo or no therapy, for maintenance following treatment of threatened preterm labour. Data collection and analysis: Two review authors independently applied the selection criteria and carried out data extraction and quality assessment of studies. Main results: We did not identify any new trials from the updated search so the results remain unchanged as follows. We included 13 randomised controlled trials (RCTs) with a total of 1551 women. We found no differences for admission to the neonatal intensive care unit when betamimetics were compared with placebo (risk ratio (RR) 1.28, 95{\%} confidence interval (CI) 0.68 to 2.41; two RCTs of terbutaline with 2600 women) or with magnesium (RR 0.80, 95{\%} CI 0.43 to 1.46; one RCT of 137 women). The rate of preterm birth (less than 37 weeks) showed no significant difference in six RCTs, four comparing ritodrine with placebo/no treatment and two comparing terbutaline with placebo/no treatment (RR 1.11, 95{\%} CI 0.91 to 1.35; 644 women). We observed no differences between betamimetics and placebo, no treatment or other tocolytics for perinatal mortality and morbidity outcomes. Some adverse effects such as tachycardia were more frequent in the betamimetics groups than the groups allocated to placebo, no treatment or another type of tocolytic. Authors' conclusions: Available evidence does not support the use of oral betamimetics for maintenance therapy after threatened preterm labour.",
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Oral betamimetics for maintenance therapy after threatened preterm labour. / Dodd, Jodie M.; Crowther, Caroline A.; Middleton, Philippa.

In: Cochrane Database of Systematic Reviews, Vol. 2012, No. 12, CD003927, 12.12.2012.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Oral betamimetics for maintenance therapy after threatened preterm labour

AU - Dodd, Jodie M.

AU - Crowther, Caroline A.

AU - Middleton, Philippa

PY - 2012/12/12

Y1 - 2012/12/12

N2 - Background: Some women who have threatened to give birth prematurely, subsequently settle. They may then take oral tocolytic maintenance therapy to prevent preterm birth and to prolong gestation. Objectives: To assess the effects of oral betamimetic maintenance therapy after threatened preterm labour for preventing preterm birth. Search methods: We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 9 November 2012. Selection criteria: Randomised controlled trials comparing oral betamimetic with alternative tocolytic therapy, placebo or no therapy, for maintenance following treatment of threatened preterm labour. Data collection and analysis: Two review authors independently applied the selection criteria and carried out data extraction and quality assessment of studies. Main results: We did not identify any new trials from the updated search so the results remain unchanged as follows. We included 13 randomised controlled trials (RCTs) with a total of 1551 women. We found no differences for admission to the neonatal intensive care unit when betamimetics were compared with placebo (risk ratio (RR) 1.28, 95% confidence interval (CI) 0.68 to 2.41; two RCTs of terbutaline with 2600 women) or with magnesium (RR 0.80, 95% CI 0.43 to 1.46; one RCT of 137 women). The rate of preterm birth (less than 37 weeks) showed no significant difference in six RCTs, four comparing ritodrine with placebo/no treatment and two comparing terbutaline with placebo/no treatment (RR 1.11, 95% CI 0.91 to 1.35; 644 women). We observed no differences between betamimetics and placebo, no treatment or other tocolytics for perinatal mortality and morbidity outcomes. Some adverse effects such as tachycardia were more frequent in the betamimetics groups than the groups allocated to placebo, no treatment or another type of tocolytic. Authors' conclusions: Available evidence does not support the use of oral betamimetics for maintenance therapy after threatened preterm labour.

AB - Background: Some women who have threatened to give birth prematurely, subsequently settle. They may then take oral tocolytic maintenance therapy to prevent preterm birth and to prolong gestation. Objectives: To assess the effects of oral betamimetic maintenance therapy after threatened preterm labour for preventing preterm birth. Search methods: We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 9 November 2012. Selection criteria: Randomised controlled trials comparing oral betamimetic with alternative tocolytic therapy, placebo or no therapy, for maintenance following treatment of threatened preterm labour. Data collection and analysis: Two review authors independently applied the selection criteria and carried out data extraction and quality assessment of studies. Main results: We did not identify any new trials from the updated search so the results remain unchanged as follows. We included 13 randomised controlled trials (RCTs) with a total of 1551 women. We found no differences for admission to the neonatal intensive care unit when betamimetics were compared with placebo (risk ratio (RR) 1.28, 95% confidence interval (CI) 0.68 to 2.41; two RCTs of terbutaline with 2600 women) or with magnesium (RR 0.80, 95% CI 0.43 to 1.46; one RCT of 137 women). The rate of preterm birth (less than 37 weeks) showed no significant difference in six RCTs, four comparing ritodrine with placebo/no treatment and two comparing terbutaline with placebo/no treatment (RR 1.11, 95% CI 0.91 to 1.35; 644 women). We observed no differences between betamimetics and placebo, no treatment or other tocolytics for perinatal mortality and morbidity outcomes. Some adverse effects such as tachycardia were more frequent in the betamimetics groups than the groups allocated to placebo, no treatment or another type of tocolytic. Authors' conclusions: Available evidence does not support the use of oral betamimetics for maintenance therapy after threatened preterm labour.

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U2 - 10.1002/14651858.CD003927.pub3

DO - 10.1002/14651858.CD003927.pub3

M3 - Review article

VL - 2012

JO - The Cochrane database of systematic reviews

T2 - The Cochrane database of systematic reviews

JF - The Cochrane database of systematic reviews

SN - 1469-493X

IS - 12

M1 - CD003927

ER -