Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Am J Obstet Gynecol. 2011 Feb;204(2):134.e1-20. doi: 10.1016/j.ajog.2010.11.038.
To determine the efficacy and safety of nifedipine as a tocolytic agent in women with preterm labor.
A systematic review and metaanalysis of randomized controlled trials.
Twenty-six trials (2179 women) were included. Nifedipine was associated with a significant reduction in the risk of delivery within 7 days of initiation of treatment and before 34 weeks' gestation, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, neonatal jaundice, and admission to the neonatal intensive care unit when compared with β₂-adrenergic-receptor agonists. There was no difference between nifedipine and magnesium sulfate in tocolytic efficacy. Nifedipine was associated with significantly fewer maternal adverse events than β₂-adrenergic-receptor agonists and magnesium sulfate. Maintenance nifedipine tocolysis was ineffective in prolonging gestation or improving neonatal outcomes when compared with placebo or no treatment.
Nifedipine is superior to β₂-adrenergic-receptor agonists and magnesium sulfate for tocolysis in women with preterm labor.
评估硝苯地平治疗早产孕妇的疗效和安全性。
系统评价和荟萃分析随机对照试验。
共纳入 26 项试验（2179 名女性）。与β₂-肾上腺素能受体激动剂相比，硝苯地平治疗开始后 7 天内和 34 周前分娩、呼吸窘迫综合征、坏死性小肠结肠炎、脑室出血、新生儿黄疸和新生儿重症监护病房入院的风险显著降低。硝苯地平与硫酸镁在保胎效果方面没有差异。硝苯地平与β₂-肾上腺素能受体激动剂和硫酸镁相比，母亲不良事件明显较少。与安慰剂或不治疗相比，维持性硝苯地平保胎并不能延长妊娠时间或改善新生儿结局。
硝苯地平治疗早产孕妇的保胎效果优于β₂-肾上腺素能受体激动剂和硫酸镁。
