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Oral betamimetics for maintenance therapy after threatened
pretermlabour(Review)
DoddJM,CrowtherCA,DareMR,MiddletonP
ThisisareprintofaCochranereview,preparedandmaintained byTheCochraneCollaborationandpublishedinTheCochraneLibrary
2007, Issue 2
http://www.thecochranelibrary.com
Oral betamimetics for maintenance therapy after threatened preterm labour (Review) 1
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
TABLE OF CONTENTS
ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
PLAINLANGUAGESUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
CRITERIAFORCONSIDERINGSTUDIESFORTHISREVIEW . . . . . . . . . . . . . . . . . . 2
SEARCHMETHODSFORIDENTIFICATIONOFSTUDIES . . . . . . . . . . . . . . . . . . . 3
METHODSOFTHEREVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DESCRIPTIONOFSTUDIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
METHODOLOGICALQUALITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
AUTHORS’CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
POTENTIALCONFLICTOFINTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
SOURCESOFSUPPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Characteristics of included studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Characteristics of excluded studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
ANALYSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Comparison 01. Betamimetic versus placebo/no treatment (primary outcomes) . . . . . . . . . . . . . 15
Comparison 02. Betamimetic versus placebo/no treatment (infant outcomes) . . . . . . . . . . . . . . 16
Comparison 03. Betamimetic versus placebo/no treatment (maternal outcomes) . . . . . . . . . . . . . 16
Comparison 04. Betamimetic versus placebo/no treatment (preterm birth and hospital admissions) . . . . . . 16
Comparison 05. Terbutaline versus indomethacin (primary outcomes) . . . . . . . . . . . . . . . . 16
Comparison 06. Terbutaline versus indomethacin (infant outcomes) . . . . . . . . . . . . . . . . . 16
Comparison 07. Terbutaline versus indomethacin (maternal outcomes) . . . . . . . . . . . . . . . . 17
Comparison 08. Terbutaline versus indomethacin (preterm birth and hospital admissions) . . . . . . . . . 17
Comparison 09. Terbutaline versus ritodrine (primary outcomes) . . . . . . . . . . . . . . . . . . 17
Comparison 10. Terbutaline versus ritodrine (infant outcomes) . . . . . . . . . . . . . . . . . . . 17
Comparison 11. Terbutaline versus ritodrine (maternal outcomes) . . . . . . . . . . . . . . . . . . 17
Comparison 12. Terbutaline versus ritodrine (preterm birth and hospital admissions) . . . . . . . . . . . 17
Comparison 13. Betamimetic versus magnesium (primary outcomes) . . . . . . . . . . . . . . . . . 18
Comparison 14. Betamimetic versus magnesium (infant outcomes) . . . . . . . . . . . . . . . . . 18
Comparison 15. Betamimetic versus magnesium (maternal outcomes) . . . . . . . . . . . . . . . . 18
Comparison 16. Betamimetic versus magnesium (preterm birth and hospital admissions) . . . . . . . . . . 18
INDEXTERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
COVERSHEET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
GRAPHSANDOTHERTABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Analysis 01.03. Comparison 01 Betamimetic versus placebo/no treatment (primary outcomes), Outcome 03 Neonatal 20
intensive care unit admission . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.04. Comparison 01 Betamimetic versus placebo/no treatment (primary outcomes), Outcome 04 Perinatal 20
mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.01. Comparison 02 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 01 Preterm birth 21
(< 37 weeks) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.02. Comparison 02 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 02 Birthweight 22
Analysis 02.03. Comparison 02 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 03 Respiratory 23
distress syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.04. Comparison 02 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 04 Necrotising 24
enterocolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Oral betamimetics for maintenance therapy after threatened preterm labour (Review) i
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
Analysis 02.05. Comparison 02 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 05 24
Intraventricular haemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.06. Comparison 02 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 06 Neonatal 25
jaundice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 03.01. Comparison 03 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 01 Side-effects 25
sufficient to stop therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 03.02. Comparison 03 Betamimeticversus placebo/no treatment(maternaloutcomes), Outcome02Tachycardia 26
Analysis 03.03. Comparison 03 Betamimeticversusplacebo/no treatment(maternaloutcomes), Outcome03Tachypnoea 26
Analysis 03.04. Comparison 03 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 04 27
Hypotension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 03.05. Comparison 03 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 05 Nausea 27
Analysis 03.06. Comparison 03 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 06 Vomiting 28
Analysis 03.07. Comparison 03 Betamimeticversus placebo/no treatment (maternaloutcomes), Outcome07 Palpitations 28
Analysis 03.08. Comparison 03 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 08 Headache 29
Analysis 04.01. Comparison 04 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), 29
Outcome01Pretermbirth within 24 hours . . . . . . . . . . . . . . . . . . . . . . .
Analysis 04.02. Comparison 04 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), 30
Outcome02Pretermbirth within 48 hours . . . . . . . . . . . . . . . . . . . . . . .
Analysis 04.03. Comparison 04 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), 30
Outcome03Pretermbirth within 1 week . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 04.04. Comparison 04 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), 31
Outcome04Maternal antenatal readmission to hospital . . . . . . . . . . . . . . . . . . .
Analysis 05.01. Comparison 05 Terbutaline versus indomethacin (primary outcomes), Outcome 01 Very preterm birth 31
(< 34 weeks) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 05.02. Comparison 05 Terbutaline versus indomethacin (primary outcomes), Outcome 02 Neonatal mortality 32
Analysis 06.01. Comparison 06 Terbutaline versus indomethacin (infant outcomes), Outcome 01 Birthweight . . 32
Analysis 06.02. Comparison 06 Terbutaline versus indomethacin (infant outcomes), Outcome 02 Required mechanical 33
ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 06.03. Comparison 06 Terbutaline versus indomethacin (infant outcomes), Outcome 03 Days stay in neonatal 33
intensive care unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 06.04. Comparison 06 Terbutaline versus indomethacin (infant outcomes), Outcome 04 Intraventricular 34
haemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 07.01. Comparison 07 Terbutaline versus indomethacin (maternal outcomes), Outcome 01 Side-effects 34
sufficient to stop therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 08.01. Comparison 08 Terbutaline versus indomethacin (preterm birth and hospital admissions), Outcome 01 35
Preterm birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 08.02. Comparison 08 Terbutaline versus indomethacin (preterm birth and hospital admissions), Outcome 02 35
Maternal antenatal readmission to hospital . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 09.01. Comparison 09 Terbutaline versus ritodrine (primary outcomes), Outcome 01 Very preterm birth (less 36
than 34 weeks) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 10.01. Comparison 10 Terbutaline versus ritodrine (infant outcomes), Outcome 01 Preterm birth (< 37 weeks) 36
Analysis 10.02. Comparison 10 Terbutaline versus ritodrine (infant outcomes), Outcome 02 Mean birthweight . . 37
Analysis 10.03. Comparison 10 Terbutaline versus ritodrine (infant outcomes), Outcome 03 Hyperbilirubinaemia 37
(neonatal jaundice requiring phototherapy) . . . . . . . . . . . . . . . . . . . . . . .
Analysis 11.01. Comparison 11 Terbutaline versus ritodrine (maternal outcomes), Outcome 01 Tachycardia . . . 38
Analysis 11.02. Comparison 11 Terbutaline versus ritodrine (maternal outcomes), Outcome 02 Tachypnoea . . . 38
Analysis 11.03. Comparison 11 Terbutaline versus ritodrine (maternal outcomes), Outcome 03 Nausea/vomiting . 39
Analysis 12.01. Comparison 12 Terbutaline versus ritodrine (preterm birth and hospital admissions), Outcome 01 39
Maternal antenatal readmission to hospital . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 13.01. Comparison 13 Betamimetic versus magnesium (primary outcomes), Outcome 01 Neonatal intensive 40
care unit admisssion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 13.02. Comparison 13 Betamimetic versus magnesium (primary outcomes), Outcome 02 Perinatal mortality 40
Oral betamimetics for maintenance therapy after threatened preterm labour (Review) ii
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
Analysis 14.01. Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 01 Preterm birth (< 37 41
weeks) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 14.02. Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 02 Birthweight . . . 42
Analysis 14.03. Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 03 Respiratory distress 42
syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 14.04. Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 04 Intraventricular 43
haemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 14.05. Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 05 Neonatal jaundice . 43
Analysis 15.01. Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 01 Side-effects sufficient 44
to stop medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 15.02. Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 02 Tachycardia/ 45
palpitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 15.03. Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 03 Tachypnoea . . 45
Analysis 15.04. Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 04 Nausea . . . . 46
Analysis 15.05. Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 05 Vomiting . . . 47
Analysis 15.06. Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 06 Chest pain . . 47
Analysis 16.01. Comparison 16 Betamimetic versus magnesium (preterm birth and hospital admissions), Outcome 01 48
Maternal antenatal readmission to hospital . . . . . . . . . . . . . . . . . . . . . . . .
Oral betamimetics for maintenance therapy after threatened preterm labour (Review) iii
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
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