Nifedipine maintenance tocolysis and perinatal outcome: an individual participant data meta-analysis

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dc.authoridSchuit, Ewoud/0000-0002-9548-3214
dc.authoridMahdy, Zaleha Abdullah/0000-0003-0856-0697
dc.authoridvan der Post, Joris/0000-0003-3311-2116
dc.authoridOudijk, Martijn/0000-0001-8672-4365
dc.authoridMcCowan, Lesley/0000-0001-9915-7873
dc.authorwosidSAYIN, N. CENK/A-5801-2018
dc.authorwosidMol, Ben/I-4526-2012
dc.authorwosidSchuit, Ewoud/N-1869-2014
dc.authorwosidMcCowan, Lesley/C-2215-2009
dc.authorwosidvan der Post, Joris A M/A-8991-2008
dc.authorwosidMahdy, Zaleha Abdullah/B-4061-2009
dc.authorwosidOudijk, Martijn/C-1520-2019
dc.contributor.authorvan Vliet, E. O. G.
dc.contributor.authorDijkema, G. H.
dc.contributor.authorSchuit, E.
dc.contributor.authorHeida, K. Y.
dc.contributor.authorRoos, C.
dc.contributor.authorvan der Post, J. A. M.
dc.contributor.authorParry, E. C.
dc.date.accessioned2024-06-12T11:03:46Z
dc.date.available2024-06-12T11:03:46Z
dc.date.issued2016
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackgroundPreterm birth is the leading cause of neonatal mortality and morbidity in developed countries. Whether continued tocolysis after 48hours of rescue tocolysis improves neonatal outcome is unproven. ObjectivesTo evaluate the effectiveness of maintenance tocolytic therapy with oral nifedipine on the reduction of adverse neonatal outcomes and the prolongation of pregnancy by performing an individual patient data meta-analysis (IPDMA). Search strategyWe searched PubMed, Embase, and Cochrane databases for randomised controlled trials of maintenance tocolysis therapy with nifedipine in preterm labour. Selection criteriaWe selected trials including pregnant women between 24 and 36(6/7)weeks of gestation (gestational age, GA) with imminent preterm labour who had not delivered after 48hours of initial tocolysis, and compared maintenance nifedipine tocolysis with placebo/no treatment. Data collection and analysisThe primary outcome was perinatal mortality. Secondary outcome measures were intraventricular haemorrhage (IVH), necrotising enterocolitis (NEC), infant respiratory distress syndrome (IRDS), prolongation of pregnancy, GA at delivery, birthweight, neonatal intensive care unit admission, and number of days on ventilation support. Pre-specified subgroup analyses were performed. Main resultsSix randomised controlled trials were included in this IPDMA, encompassing data from 787 patients (n=390 for nifedipine; n=397 for placebo/no treatment). There was no difference between the groups for the incidence of perinatal death (risk ratio, RR1.36; 95% confidence interval, 95%CI 0.35-5.33), intraventricular haemorrhage (IVH)gradeII (RR0.65; 95%CI 0.16-2.67), necrotising enterocolitis (NEC) (RR1.15; 95%CI 0.50-2.65), infant respiratory distress syndrome (IRDS) (RR0.98; 95%CI 0.51-1.85), and prolongation of pregnancy (hazard ratio, HR0.74; 95%CI 0.55-1.01). ConclusionMaintenance tocolysis is not associated with improved perinatal outcome and is therefore not recommended for routine practice. Tweetable abstractNifedipine maintenance tocolysis is not associated with improved perinatal outcome or pregnancy prolongation. Tweetable abstract Nifedipine maintenance tocolysis is not associated with improved perinatal outcome or pregnancy prolongation.en_US
dc.description.sponsorshipDutch Ter Meulen Fund of the Royal Netherlands Academy of Arts and Sciencesen_US
dc.description.sponsorshipWe thank all authors of the original studies for sharing their data. EOG van Vliet was supported by a travel grant of the Dutch Ter Meulen Fund of the Royal Netherlands Academy of Arts and Sciences.en_US
dc.identifier.doi10.1111/1471-0528.14249
dc.identifier.endpage1760en_US
dc.identifier.issn1470-0328
dc.identifier.issn1471-0528
dc.identifier.issue11en_US
dc.identifier.pmid27550838en_US
dc.identifier.scopus2-s2.0-84988419426en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1753en_US
dc.identifier.urihttps://doi.org/10.1111/1471-0528.14249
dc.identifier.urihttps://hdl.handle.net/20.500.14551/21783
dc.identifier.volume123en_US
dc.identifier.wosWOS:000384679100004en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofBjog-An International Journal Of Obstetrics And Gynaecologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectIndividual Participant Data Meta-Analysisen_US
dc.subjectMaintenance Tocolysisen_US
dc.subjectNifedipineen_US
dc.subjectOutcomeen_US
dc.subjectPreterm Birthen_US
dc.subjectPreterm Laboren_US
dc.subjectRandomized-Trialsen_US
dc.subjectOral Nifedipineen_US
dc.subjectTherapyen_US
dc.subjectBirthen_US
dc.subjectPlaceboen_US
dc.subjectWomenen_US
dc.titleNifedipine maintenance tocolysis and perinatal outcome: an individual participant data meta-analysisen_US
dc.typeReview Articleen_US

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