HCPLive Network

Nifedipine-Maintained Tocolysis No Benefit in Perinatal Outcomes

 
FRIDAY, Jan. 4 (HealthDay News) -- For women threatened with preterm labor, maintenance tocolysis with nifedipine is not associated with a significant reduction in adverse perinatal outcomes, according to a study published in the Jan. 1 issue of the Journal of the American Medical Association.

Carolien Roos, M.D., from the Radboud University Medical Center in Nijmegen, Netherlands, and colleagues conducted a randomized, double-blind, placebo-controlled study in 11 perinatal units in all tertiary centers in the Netherlands to examine whether maintenance tocolysis with nifedipine would reduce adverse perinatal outcome linked to premature birth. Women with threatened preterm labor between 26 and 32 weeks of gestation, who had not delivered after 48 hours of tocolysis and a completed course of corticosteroids, were randomized to oral nifedipine (201 women) or placebo (205 women) for 12 days. Surviving infants were followed for six months.

The researchers observed no significant between-group difference in adverse perinatal outcome (11.9 percent for nifedipine versus 13.7 percent for placebo; relative risk, 0.87; 95 percent confidence interval, 0.53 to 1.45).

"It seems likely that the absence of any effect is not due to ineffectiveness of nifedipine as a uterine relaxant," the authors write. "Apparently, symptomatic treatment of uterine contractions with any uterine relaxant is ineffective when used as maintenance therapy. The etiology of threatened preterm labor is multifaceted and includes subclinical intrauterine infection. Future research should be directed toward therapies tailored to the specific underlying causes of preterm labor."

One author disclosed a financial tie to CSL Behring, and one author reported provision of expert testimony to courts, payment for lectures, and private/unrelated stock/stock options.
 

Abstract
Full Text (subscription or payment may be required)

Copyright © 2013 HealthDay. All rights reserved.
 

Further Reading
Research indicates that there are probable etiologies of low back pain that can affect treatment outcome and that ignoring pain can possibly cause chronic neurological changes.
Researchers are learning more about the ways in which gut microbiota interact with the central nervous system and the role this can play in pain management.
Although the underlying mechanisms are not fully understood, opioid-induced hyperalgesia occurs in some patients on higher doses of opioids. Treatment options include reducing, rotating, or completely tapering the opioid regimen.
Magnetic resonance is an effective alternative to biopsy for identifying and quantifying fats in the liver, according to results from a study led by a research team at the University of the Basque Country.
Daily supplements of selenium or vitamin E don't seem to protect against the development of age-related cataracts among men, according to a study published online Sept. 18 in JAMA Ophthalmology.
Workplace flu shots are a good investment, a new survey found. The US Centers for Disease Control and Prevention (CDC) on Sept. 19 urged all health care personnel to get flu vaccinations. The CDC also released the results of a survey of 1,882 health care clinicians meant to determine what factors influenced those who got the shots. Among its findings, when workplaces offered free shots on-site, compliance was 61.6% when the vaccinations were offered for one day only. When they were offered for multiple days, compliance rose to 80.4%. When employers did not offer the shots at all, compliance dropped to 49.0%
Cancer patients burdened by stress and family conflicts before surgery may face a higher risk for complications following their operation, according to a study published in a recent issue of the Journal of Gastrointestinal Surgery.
More Reading