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Calcium channel blockers for inhibiting preterm labour
J F King1, V J Flenady, D N Papatsonis
1Department of Perinatal Medicine, Royal Women's Hospital, Carlton, Victoria, Australia, 3053. jfking@unimelb.edu.au
The Cochrane Database of Systematic Reviews
|June 22, 2002
Summary
Calcium channel blockers are a safer and more effective tocolytic agent for preterm labor compared to betamimetics. These drugs reduce the risk of preterm birth and adverse neonatal outcomes like respiratory distress syndrome.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Neonatology
Background:
- Preterm birth is a leading cause of infant mortality and morbidity.
- Tocolytics, such as betamimetics, are used to suppress preterm labor but have significant maternal side effects and do not improve perinatal outcomes.
- Calcium channel blockers are emerging as a well-tolerated and potentially effective tocolytic alternative.
Purpose of the Study:
- To evaluate the efficacy and safety of calcium channel blockers as tocolytic agents in women experiencing preterm labor.
- To assess the impact of calcium channel blockers on maternal, fetal, and neonatal outcomes.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials were conducted.
- Eleven trials involving 870 women were included, comparing calcium channel blockers with other tocolytic agents, primarily betamimetics.
- Data extraction and quality assessment were performed independently by three authors.
Main Results:
- Calcium channel blockers significantly reduced the incidence of birth within 48 hours and seven days compared to other tocolytics.
- Treatment cessation due to adverse drug reactions was significantly lower with calcium channel blockers.
- The frequency of neonatal respiratory distress syndrome and neonatal jaundice was reduced.
Conclusions:
- Calcium channel blockers are the preferred tocolytic agents over betamimetics for women in preterm labor.
- Further research is recommended to explore optimal dosage regimens and formulations of nifedipine for maternal and neonatal benefits.