Han Shanshan, Crowther Caroline A, Moore Vivienne
ARCH: Australian Research Centre for Health of Women and Babies, The Robinson Institute, Discipline of Obstetrics and Gynaecology,The University of Adelaide, Adelaide, Australia.
Cochrane Database Syst Rev. 2013 May 31;2013(5):CD000940. doi: 10.1002/14651858.CD000940.pub3.
Magnesium maintenance therapy is one of the types of tocolytic therapy used after an episode of threatened preterm labour (usually treated with an initial dose of tocolytic therapy) in an attempt to prevent the onset of further preterm contractions.
To assess whether magnesium maintenance therapy is effective in preventing preterm birth after the initial threatened preterm labour is arrested.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2013).
Randomised controlled trials of magnesium therapy given to women after threatened preterm labour.
The review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We checked data entry.
We included four trials involving 422 women. Three trials had high risk of bias and none included any long-term follow-up of infants. No differences in the incidence of preterm birth or perinatal mortality were seen when magnesium maintenance therapy was compared with placebo or no treatment; or alternative therapies (ritodrine or terbutaline). The risk ratio (RR) for preterm birth (less than 37 weeks) for magnesium compared with placebo or no treatment was 1.05, 95% confidence interval (CI) 0.80 to 1.40 (two trials, 99 women); and 0.99, 95% CI 0.57 to 1.72 (two trials, 100 women) for magnesium compared with alternative therapies. The RR for perinatal mortality for magnesium compared with placebo or no treatment was 5.00, 95% CI 0.25 to 99.16 (one trial, 50 infants); and 5.00, 95% CI 0.25 to 99.16 (one trial, 50 infants) for magnesium compared with alternative treatments.Women taking magnesium preparations were less likely to report side effects (RR 0.67, 95% CI 0.47 to 0.96, three trials, 237 women), including palpitations or tachycardia (RR 0.26, 95% CI 0.13 to 0.52, three trials, 237 women) than women receiving alternative therapies. Women receiving magnesium were however, more likely to experience diarrhoea (RR 6.79, 95% CI 1.26 to 36.72, three trials, 237 women).
AUTHORS' CONCLUSIONS: There is not enough evidence to show any difference between magnesium maintenance therapy compared with either placebo or no treatment, or alternative therapies (ritodrine or terbutaline) in preventing preterm birth after an episode of threatened preterm labour.
镁剂维持疗法是在先兆早产发作后（通常先用一剂宫缩抑制剂治疗）使用的宫缩抑制疗法之一，旨在预防进一步早产宫缩的发作。
评估镁剂维持疗法在最初的先兆早产得到控制后预防早产是否有效。
我们检索了Cochrane妊娠与分娩组试验注册库（2013年1月31日）。
对先兆早产妇女给予镁剂治疗的随机对照试验。
综述作者独立评估纳入研究，评估偏倚风险并进行数据提取。我们检查了数据录入情况。
我们纳入了4项涉及422名妇女的试验。3项试验存在高偏倚风险，且均未对婴儿进行任何长期随访。与安慰剂或不治疗相比；或与其他疗法（利托君或特布他林）相比，镁剂维持疗法在早产发生率或围产期死亡率方面未见差异。与安慰剂或不治疗相比，镁剂治疗早产（小于37周）的风险比（RR）为1.05，95%置信区间（CI）为0.80至1.40（2项试验，99名妇女）；与其他疗法相比，镁剂治疗早产的RR为0.99，95%CI为0.57至1.72（2项试验，100名妇女）。与安慰剂或不治疗相比，镁剂治疗围产期死亡率的RR为5.00，95%CI为0.25至99.16（1项试验，50名婴儿）；与其他治疗相比，镁剂治疗围产期死亡率的RR为5.00，95%CI为0.25至99.16（1项试验，50名婴儿）。服用镁剂制剂的妇女报告副作用的可能性较小（RR 0.67，95%CI 0.47至0.96，3项试验，237名妇女），包括心悸或心动过速（RR 0.26，95%CI 0.13至0.52，3项试验，237名妇女），而接受其他疗法的妇女则不然。然而，接受镁剂治疗的妇女更易出现腹泻（RR 6.79，95%CI 1.26至36.72，3项试验，237名妇女）。
没有足够证据表明在先兆早产发作后预防早产方面，镁剂维持疗法与安慰剂或不治疗，或与其他疗法（利托君或特布他林）之间存在任何差异。
