Beta‐mimetics in preterm labour: an overview of the randomized controlled trials

Summary. Controversy continues about the use of beta‐mimetic drugs in preterm labour. One reason for this is that the adequately controlled trials of these drugs have all been small and have thus provided very imprecise estimates of their effects. We have therefore conducted a‘meta‐analysis’ using data relating to 890 women who participated in the 16 methodologically acceptable controlled trials of these agents in the treatment of preterm labour. This analysis demonstrates an unequivocal effect of beta‐mimetic tocolytic administration in delaying delivery, and this is reflected in a reduction in the frequency of preterm birth and low birthweight. However, no beneficial effect of this treatment on perinatal mortality or severe neonatal respiratory disorders could be detected.

[1]  M. Keirse.  Betamimetic drugs in the prophylaxis of preterm labour: extent and rationale of their use , 1984, British journal of obstetrics and gynaecology.

[2]  I. Ingemarsson,et al.  Effect of Ritodrine on Labor After Premature Rupture of the Membranes , 1980, Obstetrics and gynecology.

[3]  J. Parer,et al.  Oral ritodrine maintenance in the treatment of preterm labor. , 1980, American journal of obstetrics and gynecology.

[4]  I. Ingemarsson.  Effect of terbutaline on premature labor. A double-blind placebo-controlled study. , 1976, American journal of obstetrics and gynecology.

[5]  W. Spellacy,et al.  Treatment of premature labor with ritodrine: a randomized controlled study. , 1979, Obstetrics and gynecology.

[6]  P. Biron.  Premature labour , 1976, Canadian Medical Association journal.

[7]  L Mutch,et al.  The Oxford Database of Perinatal Trials: developing a register of published reports of controlled trials. , 1986, Controlled clinical trials.

[8]  B. Starfield,et al.  PREVENTION AND TREATMENT OF PREMATURE LABOUR BY DRUGS: REVIEW OF CONTROLLED CLINICAL TRIALS , 1978, British journal of obstetrics and gynaecology.

[9]  M. Thiéry,et al.  Results of Double-blind, Multicentre Study with Ritodrine in Premature Labour , 1971, British medical journal.

[10]  A. Csapo,et al.  Arrest of premature labor by isoxsuprine. , 1977, American journal of obstetrics and gynecology.

[11]  R. Laros,et al.  The cost effectiveness of stopping preterm labor with beta-adrenergic treatment. , 1984, The New England journal of medicine.

[12]  Treatment of Imminent Premature Labour , 1975, Acta obstetricia et gynecologica Scandinavica.

[13]  I. Merkatz,et al.  Ritodrine Hydrochloride: A Betamimetic Agent for Use in Preterm Labor. II. Evidence Of Efficacy , 1980, Obstetrics and gynecology.

[14]  J. Baum,et al.  Contribution of preterm delivery to perinatal mortality. , 1976, British medical journal.

[15]  M. Keirse,et al.  A survey of tocolytic drug treatment in preterm labour , 1984, British journal of obstetrics and gynaecology.

[16]  G. S. Adam.  Isoxuprine and Premature Labour , 1966, The Australian & New Zealand journal of obstetrics & gynaecology.

[17]  B. Schifrin,et al.  Comparison of magnesium sulfate, terbutaline and a placebo for inhibition of preterm labor. A randomized study. , 1984, The Journal of reproductive medicine.

[18]  M. Osler,et al.  Ritodrine in the treatment of preterm labor: second Danish Multicenter Study. , 1986, Obstetrics and gynecology.

[19]  G. Hankins,et al.  SINGLE-CENTRE RANDOMISED TRIAL OF RITODRINE HYDROCHLORIDE FOR PRETERM LABOUR , 1986, The Lancet.

[20]  M. Osler,et al.  RITODRINE IN THE TREATMENT OF PRETERM , 1980 .

[21]  P. Armitage,et al.  Design and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design. , 1976, British Journal of Cancer.