Maintenance therapy with calcium channel blockers for preventing preterm birth after threatened preterm labour

Naik Gaunekar N, Crowther CA

Published Online:

February 17, 2010

The role of maintenance therapy with calcium channel blockers for preventing preterm birth is not clear.

Premature babies may not survive or may have serious long-term problems if they do survive. After other drugs have been used to try to stop early labour, calcium channel blockers can be used to prevent further early contractions. This review did not show that calcium channel blockers (used in this way) helped to prevent preterm birth, but this was based on a single study, which did not look at infants' later development.

Abstract (click to read)

Background:

Calcium channel blocker maintenance therapy is one of the types of tocolytic therapy used after an episode of threatened preterm labour (and usually an initial dose of tocolytic therapy) in an attempt to prevent the onset of further preterm contractions.

Objectives:

To assess the effects of calcium channel blockers as maintenance therapy on preventing preterm birth after threatened preterm labour.

Search strategy:

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2004); MEDLINE (1966 to March 2004) and DARE (June 2003). We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 1 October 2009 and added the results to the awaiting classification section.

Selection criteria:

Randomised controlled trials of calcium channel blockers used as maintenance therapy to prevent preterm birth after threatened preterm labour, compared with alternative drug therapy, placebo or no treatment.

Data collection and analysis:

Two reviewers independently applied the selection criteria, extracted data from the included study and assessed study quality.

Main results:

One trial of 74 women was included. No difference in the incidence of preterm birth was found when calcium channel blocker (nifedipine) maintenance therapy was compared with no treatment. Twenty-five women out of 37 in each group gave birth before 37 weeks (relative risk 1.00, 95% confidence interval 0.73 to 1.37). The trial did not report stillbirths and neonatal deaths prior to discharge. Neurological follow up of the infants was not addressed.

Authors' conclusions:

The role of maintenance therapy with calcium channel blockers for preventing preterm birth is not clear. Well designed randomised trials of sufficient size with relevant outcomes are required.

[Note: The four citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

This record should be cited as:

Naik Gaunekar N, Crowther CA. Maintenance therapy with calcium channel blockers for preventing preterm birth after threatened preterm labour. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004071. DOI: 10.1002/14651858.CD004071.pub2

Assessed as up to date:

March 31, 2004

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Primary Review Group:

Pregnancy and Childbirth Group

Health topics:

Pregnancy & childbirth > Preterm labour > Maintenance

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Maintenance therapy with calcium channel blockers for preventing preterm birth after threatened preterm labour

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