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Effectiveness of nifedipine versus atosiban for tocolysis in preterm labour: a meta-analysis with an indirect comparison of randomised trials.
BJOG. 2003 Dec; 110(12):1045-9.BJOG

Abstract

OBJECTIVE

To explore the effectiveness of nifedipine compared with atosiban for tocolysis in preterm labour.

DESIGN

A systematic review of randomised controlled trials with meta-analysis using adjusted indirect comparison.

POPULATION

Six hundred and seventy-nine women recruited in nine randomised trials evaluating the effectiveness of nifedipine versus beta-agonists, and 852 women recruited in four trials of atosiban versus beta-agonists. There were no trials comparing nifedipine directly with atosiban.

METHODS

We performed meta-analysis with a technique involving an adjusted indirect comparison between nifedipine and atosiban using beta-agonists as the common comparator. This approach preserves the benefit accrued by randomisation in the original comparisons.

MAIN OUTCOME MEASURES

Reduction in neonatal respiratory distress syndrome and delay in delivery by 48 hours.

RESULTS

Nifedipine tocolysis was associated with a significant reduction in respiratory distress syndrome compared with atosiban (OR 0.55, 95% CI 0.32-0.97). It also increased the number of women whose delivery was delayed by 48 hours (OR 1.20, 95% CI 0.73-1.95), although this result was not statistically significant.

CONCLUSIONS

When indirectly compared with atosiban, nifedipine tocolysis is more effective. In the absence of a direct comparison, our analysis provides a way to explore the potential benefits of nifedipine versus atosiban.

Authors+Show Affiliations

Education Resource Centre, Birmingham Women's Hospital, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

14664874

Citation

Coomarasamy, Aravinthan, et al. "Effectiveness of Nifedipine Versus Atosiban for Tocolysis in Preterm Labour: a Meta-analysis With an Indirect Comparison of Randomised Trials." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 110, no. 12, 2003, pp. 1045-9.
Coomarasamy A, Knox EM, Gee H, et al. Effectiveness of nifedipine versus atosiban for tocolysis in preterm labour: a meta-analysis with an indirect comparison of randomised trials. BJOG. 2003;110(12):1045-9.
Coomarasamy, A., Knox, E. M., Gee, H., Song, F., & Khan, K. S. (2003). Effectiveness of nifedipine versus atosiban for tocolysis in preterm labour: a meta-analysis with an indirect comparison of randomised trials. BJOG : an International Journal of Obstetrics and Gynaecology, 110(12), 1045-9.
Coomarasamy A, et al. Effectiveness of Nifedipine Versus Atosiban for Tocolysis in Preterm Labour: a Meta-analysis With an Indirect Comparison of Randomised Trials. BJOG. 2003;110(12):1045-9. PubMed PMID: 14664874.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of nifedipine versus atosiban for tocolysis in preterm labour: a meta-analysis with an indirect comparison of randomised trials. AU - Coomarasamy,Aravinthan, AU - Knox,Ellen M, AU - Gee,Harry, AU - Song,Fujian, AU - Khan,Khalid S, PY - 2003/12/11/pubmed PY - 2004/1/27/medline PY - 2003/12/11/entrez SP - 1045 EP - 9 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 110 IS - 12 N2 - OBJECTIVE: To explore the effectiveness of nifedipine compared with atosiban for tocolysis in preterm labour. DESIGN: A systematic review of randomised controlled trials with meta-analysis using adjusted indirect comparison. POPULATION: Six hundred and seventy-nine women recruited in nine randomised trials evaluating the effectiveness of nifedipine versus beta-agonists, and 852 women recruited in four trials of atosiban versus beta-agonists. There were no trials comparing nifedipine directly with atosiban. METHODS: We performed meta-analysis with a technique involving an adjusted indirect comparison between nifedipine and atosiban using beta-agonists as the common comparator. This approach preserves the benefit accrued by randomisation in the original comparisons. MAIN OUTCOME MEASURES: Reduction in neonatal respiratory distress syndrome and delay in delivery by 48 hours. RESULTS: Nifedipine tocolysis was associated with a significant reduction in respiratory distress syndrome compared with atosiban (OR 0.55, 95% CI 0.32-0.97). It also increased the number of women whose delivery was delayed by 48 hours (OR 1.20, 95% CI 0.73-1.95), although this result was not statistically significant. CONCLUSIONS: When indirectly compared with atosiban, nifedipine tocolysis is more effective. In the absence of a direct comparison, our analysis provides a way to explore the potential benefits of nifedipine versus atosiban. SN - 1470-0328 UR - https://www.unboundmedicine.com/medline/citation/14664874/Effectiveness_of_nifedipine_versus_atosiban_for_tocolysis_in_preterm_labour:_a_meta_analysis_with_an_indirect_comparison_of_randomised_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1470032803039715 DB - PRIME DP - Unbound Medicine ER -