Ethanol for preventing preterm birth in threatened preterm labor

Area of Science:

• Obstetrics and Gynecology
• Neonatal Health
• Pharmacology

Background:

• Preterm birth is a leading global cause of neonatal mortality and disability.
• Ethanol was an early tocolytic agent but is rarely used due to safety concerns.
• This review evaluates ethanol's efficacy and safety in managing preterm labor.

Purpose of the Study:

• To assess the effectiveness of ethanol in halting preterm labor.
• To determine ethanol's impact on preventing preterm birth.
• To evaluate ethanol's effects on neonatal outcomes.

Main Methods:

• Searched Cochrane Pregnancy and Childbirth Group's Trials Register and study references.
• Included randomized and quasi-randomized controlled trials comparing ethanol to placebo or other tocolytics.
• Assessed study inclusion, risk of bias, and extracted data independently.

Main Results:

• Ethanol did not improve outcomes compared to placebo, including birth within 48 hours or neonatal mortality.
• Compared to betamimetics, ethanol showed no clear difference in birth delay but higher neonatal mortality and preterm birth rates (<34 weeks).
• Ethanol had a trend towards fewer maternal adverse events requiring drug cessation, but this was based on limited data.

Conclusions:

• Evidence suggests ethanol is not an effective tocolytic agent compared to placebo.
• Ethanol appears inferior to betamimetics for preventing preterm birth.
• Due to safety concerns and limited efficacy, ethanol is not recommended for preterm labor; long-term infant follow-up is suggested.