Nifedipine in the management of preterm labor: a systematic review and metaanalysis.
Nifedipine in the management of preterm labor: a systematic review and metaanalysis.
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DOI：
10.1016/j.ajog.2010.11.038
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发表时间：
2011-02
影响因子：
9.8
通讯作者：
Kusanovic JP
中科院分区：
文献类型：
--
作者：
Conde-Agudelo A;Romero R;Kusanovic JP
目的探讨硝苯地平用于早产孕妇的保胎效果及安全性。随机对照试验的系统综述和荟萃分析。纳入了26项试验，涉及2179名女性。硝苯地平与开始治疗后7天内分娩风险显著降低相关（相对风险[RR]，0.82; 95%置信区间[CI]，0.70- 0.097）和妊娠34周前（RR，0.77; 95% CI，0.66-0.91），呼吸窘迫综合征（RR，0.63; 95% CI，0.46-0.86），坏死性小肠结肠炎（RR，0.21; 95% CI，0.05-0.94），脑室内出血（RR，0.53; 95% CI，0.34-0.84），新生儿黄疸（RR，0.73; 95% CI，0.57-0.93）和新生儿重症监护室入院（RR，0.76; 95% CI，0.62-0.93）。仅限于高质量试验的敏感性分析证实了这些结果。硝苯地平和硫酸镁在治疗后48小时内分娩，或在34周或37周前分娩方面没有差异。与β2-肾上腺素能受体激动剂和硫酸镁安胎相比，硝苯地平与母体不良事件和停止治疗的风险较低相关。与安慰剂或不治疗相比，硝苯地平维持安胎在延长妊娠或改善新生儿结局方面无效。硝苯地平上级优于β2-肾上腺素能受体激动剂和硫酸镁，应考虑作为早产管理的一线宫缩抑制剂。
To determine the efficacy and safety of nifedipine as tocolytic agent in women with preterm labor. Systematic review and metaanalysis of randomized controlled trials. Twenty-six trials involving 2179 women were included. Nifedipine was associated with a significant reduction in the risk of delivery within 7 days of initiation of treatment (relative risk [RR], 0.82; 95% confidence interval [CI], 0.70–.097) and before 34 weeks’ gestation (RR, 0.77; 95% CI, 0.66–0.91), respiratory distress syndrome (RR, 0.63; 95% CI, 0.46–0.86), necrotizing enterocolitis (RR, 0.21; 95% CI, 0.05–0.94), intraventricular hemorrhage (RR, 0.53; 95% CI, 0.34–0.84), neonatal jaundice (RR, 0.73; 95% CI, 0.57–0.93), and admission to neonatal intensive care unit (RR, 0.76; 95% CI, 0.62–0.93) when compared to β2-adrenergic-receptor agonists. Sensitivity analysis restricted to high quality trials confirmed these results. There was no difference between nifedipine and magnesium sulfate for delivery within 48 hours of treatment, or birth before 34 or 37 weeks. Nifedipine was associated with a lower risk in maternal adverse events and discontinuation of treatment than tocolysis with β2-adrenergic-receptor agonists and magnesium sulfate. Maintenance tocolysis with nifedipine was ineffective in prolonging gestation or improving neonatal outcomes when compared to placebo or no treatment. Nifedipine appears to be superior to β2-adrenergic-receptor agonists and magnesium sulfate and should be considered as the first-line tocolytic agent for the management of preterm labor.
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影响因子：
9.8
作者：
Hayes, Edward;Moroz, Leslie;Baxter, Jason
通讯作者：
Baxter, Jason
DOI：
10.1016/s0002-9378(99)70308-x
发表时间：
1999-10-01
影响因子：
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1986-01-01
影响因子：
9.8
作者：
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通讯作者：
CREASY, RK
DOI：
10.1016/s0020-7292(98)00053-8
发表时间：
1998-06-01
影响因子：
3.8
作者：
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