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Oral betamimetics for maintenance therapy after threatened preterm labourDodd JM, Crowther CA, Dare MR, Middleton P
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SummaryOral betamimetics for maintenance therapy after threatened preterm labourOral betamimetics for maintenance therapy after threatened preterm labour do not prevent preterm labour. After being successfully treated for an episode of threatened preterm birth, women may then take drugs (tocolytics) to prolong gestation so that their baby is not born too early. Oral betamimetics are one group of drugs used for this kind of maintenance therapy. In this review, betamimetics were not shown to reduce the rate of preterm birth or prevent problems with babies, when compared with placebo, no treatment or other tocolytic drugs. Betamimetics may also cause palpitations and a fast heart rate in women.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
January 25. 2006 AbstractBackgroundSome 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. ObjectivesTo assess the effects of oral betamimetic maintenance therapy after threatened preterm labour for preventing preterm birth. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2005) and MEDLINE (from 1966 to August 2003). We updated the search of the the Cochrane Pregnancy and Childbirth Group's Trials Register on 1 October 2009 and added the results to the awaiting classification section. Selection criteriaRandomised controlled trials comparing oral betamimetic with alternative tocolytic therapy, placebo or no therapy, for maintenance following treatment of threatened preterm labour. Data collection and analysisTwo review authors independently applied the selection criteria and carried out data extraction and quality assessment of studies. Main resultsEleven randomised controlled trials (RCTs) were included. No differences were seen for admission to the neonatal intensive care unit when betamimetics were compared with placebo (relative risk (RR) 1.29, 95% confidence interval (CI) 0.64 to 2.60; one RCT of terbutaline with 140 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 four RCTs, two comparing ritodrine with placebo/no treatment and two comparing terbutaline with placebo/no treatment (RR 1.08, 95% CI 0.88 to 1.32, 384 women). No differences between betamimetics and placebo, no treatment or other tocolytics were seen 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' conclusionsAvailable evidence does not support the use of oral betamimetics for maintenance therapy after threatened preterm labour. [Note: The four citations in the awaiting classification section of the review may alter conclusions of the review once assessed.] |