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

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 trials register (31 March 2004); MEDLINE (1966 to March 2004) and DARE (June 2003).

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.

REVIEWERS' 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.