Evaluation of maternal and neonatal outcomes after maintenance tocolysis: a retrospective study

This study aimed to compare maternal and neonatal outcomes after no tocolysis, short-term tocolysis (≤48h), and maintenance tocolysis (>48h).

This was a retrospective study, conducted from January 2007 to June 2008, of vaginal preterm deliveries admitted to the neonatal intensive care unit (NICU) between 23 and 36 weeks of gestation. Patients were placed in three groups: no tocolysis, tocolysis ≤48h, and tocolysis >48h. The following neonatal parameters were recorded: respiratory distress syndrome, grade III or IV intraventricular hemorrhage, culture-proven sepsis, necrotizing enterocolitis, and length of NICU stay.

A total of 162 deliveries were included in the study. Sixty-nine mothers received no tocolysis, 42 received tocolysis ≤48h, and 51 received tocolysis >48h. No adverse maternal outcomes were observed in any of the groups. There were no statistically significant differences in neonatal outcomes between the three groups. The maintenance tocolysis group had a longer pregnancy duration (P<0.0001), but their infants required longer NICU stay (P=0.0020).

This study showed that maintenance tocolysis prolongs the duration of pregnancy but does not improve neonatal outcomes. Infants of mothers in the maintenance tocolysis group showed an increase in the length of NICU stay. A multicenter randomized control trial should be considered to further evaluate the need for maintenance tocolysis.