Prevention of preterm birth |
Prevention of preterm
birth |
Prevention of preterm birth |
Prevention of
preterm birth |
Prevention of preterm birth |
Rai et al. 200930
|
DB, RCT / 150
|
History of sPTD 20–<37 weeks
Singleton pregnancy
|
Oral NMP 100 mg bd vs Placebo
From 18–24 to 36 weeks or delivery
|
Rate of PTD (<3 7 weeks) lower with oral NMP vs placebo
(39.2% vs 59.5%, p = 0.002).
Mean ± SD gestational age at delivery greater with oral NMP vs
placebo (36.1 ± 2.66 vs 34.0 ± 3.25 weeks, p <
0.001).
Oral NMP prevented sPTD between 28–<32 weeks (2.7% vs
20.3%; RR 0.20, 95% CI 0.05–0.73, p = 0.001) but not
between 32–<34 weeks (RR 0.86, 95% CI 0.60–1.22, p =
0.85) or between 34–<37 weeks (RR 0.83, 95% CI
0.48–1.45, p = 1.00) [RR of PTD with oral NMP vs
placebo with gestational age ≥ 37 weeks as reference].
Among patients requiring tocolysis, mean tocolysis-to-delivery interval
longer with oral NMP vs placebo (49.7 vs 26.8 hours,
p = 0.058).
|
Ashoush et al. 201731
|
DB, RCT / 212
|
History sPTD <37 weeks
Singleton pregnancy
|
Oral NMP 100 mg qds vs Placebo
From 14–18 to 37 weeks or delivery
|
Risk of sPTD (<37 weeks) lower with oral NMP vs placebo
(44.7% vs 63.7%; RR 0.7, 95% CI 054–0.92, p =
0.01).
Mean ± SD gestational age at delivery greater with oral NMP vs
placebo (35.4 ± 2.7 vs 33.9 ± 2.9 weeks, p = 0.01).
Patients who required tocolysis had a longer mean tocolysis-to-delivery
interval (87 ± 45.5 vs 36 ± 14.2 hours, p <
0.001).
|
Glover et al. 201132
|
DB, RCT / 33
|
History sPTD >20–<37 weeks
Singleton pregnancy
|
Oral NMP 400 mg/day vs Placebo
From 16–19 to 33 weeks
|
Rate of sPTD (<37 weeks) numerically lower with oral NMP
vs placebo, but statistical significance not achieved (26.3%
[5/19] vs 57.1% [8/14]; RR 0.55, 95% CI 0.26–1.16,
p = 0.15).
Mean ± SD gestational age at delivery not significantly longer with oral
NMP vs placebo (37.0 ± 2.7 vs 35.9 ± 3.8 weeks, p =
0.3).
|
Boelig et al. 201933
|
Meta-analysis30−32 / 386
|
History of sPTD <37 weeks
Singleton pregnancy
|
Oral NMP vs Placebo
|
Risk of preterm birth decreased at <37 weeks gestation
(relative risk [RR] 0.68; 95% CI 0.55−0.84) and at <34
weeks gestation (RR 0.55; 95% CI 0.43−0.71) with oral NMP vs
placebo.
Increased gestational age of delivery (mean difference 1.71 weeks; 95%
CI 1.11−2.30) with oral NMP vs placebo.
|
Tariq et al. 201734
|
OB / 345
|
History of PTD
Singleton (95%) or multiple pregnancy
|
Oral NMP 400 mg/day
From 15–20 weeks to delivery
|
Oral NMP prevented PTD (<37 weeks) in 67% of patients, and
PTD occurred in 33% of patients despite treatment.
Mean gestational age at time of delivery 37.51 ± 1.34 weeks.
|
Natu et al. 201735
|
RET / 30
|
High-risk for preterm labour (history of preterm labour or abortion;
infection or multiple gestation in current pregnancy)
Singleton or multiple pregnancy
|
Oral NMP vs
Vaginal progesterone suppository
From first trimestera
|
PTD rate was 40% (6/15) with oral NMP vs 26.7% (4/15) with
vaginal progesterone. Statistical analysis was not performed.
|
Maintenance tocolysis |
Maintenance tocolysis |
Maintenance tocolysis |
Maintenance tocolysis |
Maintenance tocolysis |
Noblot et al. 199136
|
DB, RCT / 44
|
Arrested preterm labour (tocolysis with ritrodrine)
|
Oral NMP 400 mg qds × 24 h then tds vs Placebo
From start of tocolysis to 35 weeks or delivery
|
Pregnancy prolongation (6.0 vs 6.4 weeks) or number of deliveries
before 37 weeks (6 vs 8) not different between oral NMP and
placebo.
Total ritrodrine dose (863 vs 1370 mg; p <
0.05) and number of days of hospitalization (13.6 vs 17.8;
p < 0.05) lower with oral NMP vs
placebo.
|
Choudhary et al. 201437
|
DB, RCT / 90
|
Arrested preterm labour (successful tocolysis with nifedipine)
Singleton pregnancy
|
Oral NMP 200 mg/day vs Placebo
From 48 hours after tocolysis to 37 weeks or delivery
|
Mean ± SD latency period (days gained until delivery) longer with oral
NMP vs placebo (33.29 ± 22.16 vs 23.07 ± 15.42 days,
p = 0.013).
Rate of PTD lower with oral NMP vs placebo (33% vs 58%,
p = 0.034).
|