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- Title
Tocolysis for inhibiting preterm birth in extremely preterm birth, multiple gestations and in growth-restricted fetuses: a systematic review and meta-analysis.
- Authors
Miyazaki, Celine; Garcia Moreno, Ralfh; Ota, Erika; Toshiyuki Swa; Oladapo, Olufemi T.; Mori, Rintaro
- Abstract
This systematic review was to identify available evidence on the effectiveness of tocolysis in inhibiting preterm delivery for women with threatened extremely preterm birth, multiple gestations, and growth-restricted babies, and their infants' outcomes. A comprehensive search using MEDLINE, Embase, the Cochrane Library, CINAHL, POPLINE and the WHO Global Health Library databases was conducted on 14 February 2014. For selection criteria, randomized controlled trials and non-randomized studies that compared tocolysis treatment to placebo or no treatment were considered. Selection of eligible studies, critical appraisal of the included studies, data collection, meta-analyses, and assessment of evidence quality were performed in accordance with the Cochrane Collaboration's guidance and validated assessment criteria. The search identified seven studies for extremely preterm birth, in which three were randomized controlled trials (RCTs) and four were non-randomized studies (non-RCTs). There were no eligible studies identified for women with multiple pregnancy and growth-restricted fetuses. Meta-analyses indicated no significant difference was found for the relative effectiveness of tocolytics versus placebo for prolonging pregnancy in women with extremely preterm birth (RR 1.04, 95 % CI 0.83 to 1.31) or reducing the rate of perinatal deaths (RR 2.22, 95 % CI 0.26 to 19.24). In summary, there is no evidence to draw conclusions on the effectiveness of tocolytic therapy for women with threatened extremely preterm birth, multiple gestations, and growth-restricted babies.
- Subjects
PREMATURE labor prevention; PREMATURE infants; TOCOLYTIC agents; CONFIDENCE intervals; FETAL growth retardation; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; LONGITUDINAL method; EVALUATION of medical care; MEDLINE; META-analysis; MULTIPLE pregnancy; PERINATAL death; PREGNANCY; RESEARCH funding; SYSTEMATIC reviews; EFFECT sizes (Statistics); RANDOMIZED controlled trials; TREATMENT effectiveness; RETROSPECTIVE studies; CASE-control method; THERAPEUTICS; PREVENTION
- Publication
Reproductive Health, 2016, Vol 13, p1
- ISSN
1742-4755
- Publication type
Article
- DOI
10.1186/s12978-015-0115-7