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Betamimetics for inhibiting preterm labour.
S Anotayanonth1, N V Subhedar, P Garner
1Chonburi Hospital, Ampur Muang, Chonburi, Thailand, 20000. dr_suchada@hotmail.com
The Cochrane Database of Systematic Reviews
|October 21, 2004
Summary
Betamimetics can delay preterm birth, especially for women needing transfer or antenatal corticosteroids. However, they cause significant adverse effects and lack evidence for specific agent superiority.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
Background:
- Preterm birth significantly contributes to global perinatal mortality and morbidity.
- Betamimetics are commonly used tocolytic agents to inhibit uterine contractions, particularly in resource-limited settings.
Purpose of the Study:
- To evaluate the efficacy and safety of betamimetics in managing preterm labor.
Main Methods:
- Systematic review of randomized controlled trials comparing betamimetics with placebo or other betamimetics.
- Searched Cochrane Pregnancy and Childbirth Group trials register (May 2003).
- Independent quality assessment and data extraction by two reviewers; intention-to-treat analyses performed.
Main Results:
- Betamimetics reduced births within 48 hours (RR 0.63) but not within seven days.
- No significant reduction in perinatal or neonatal death, or respiratory distress syndrome.
- Associated with numerous adverse effects including maternal tachycardia, tremor, hypokalemia, hyperglycemia, and fetal tachycardia.
Conclusions:
- Betamimetics can delay delivery, particularly for women requiring transfer or antenatal corticosteroids.
- Significant maternal and fetal adverse effects necessitate careful consideration.
- Insufficient evidence exists to recommend specific betamimetic agents over others.