Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Southwest Medical University, Luzhou, 646000, Sichuan, China.
Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, 643000, Sichuan, China.
Eur J Clin Pharmacol. 2024 Jun;80(6):901-910. doi: 10.1007/s00228-024-03659-9. Epub 2024 Mar 4.
To systematically review the impact of propranolol combined with oxytocin on the process and outcomes of labor.
A comprehensive literature search was performed across multiple databases, including China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biomedical Literature Database, PubMed, Embase, and the Cochrane Library. All publicly published randomized controlled trials (RCTs) of propranolol combined with oxytocin compared to the use of oxytocin alone in labor were collected. After screening the literature and extracting data, the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 recommended bias risk assessment tool was used to assess the quality of the included studies. A meta-analysis was conducted using RevMan 5.3 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the quality of evidence for outcome measures.
Meta-analysis results showed that the group receiving propranolol combined with oxytocin was more capable of reducing the cesarean section rate (eight studies, 815 women, RR = 0.67, 95% CI (0.53, 0.86), P = 0.001) and shortening the duration of the latent phase (two studies, 206 women, MD = - 1.20, 95% CI (- 1.97, - 0.43), P = 0.002) and the duration of the active phase on day 1 (two studies, 296 women, MD = - 0.69, 95% CI (- 0.83, - 0.54), P < 0.00001), compared to the oxytocin monotherapy group. No significant difference was found between the two groups in terms of the 5-min Apgar score (five studies, 609 women, MD = - 0.05, 95% CI (- 0.14, 0.04), P = 0.32) and the rate of admissions to the Neonatal Intensive Care Unit (NICU) (three studies, 359 women, RR = 0.82, 95% CI (0.38, 1.79), P = 0.62).
The combined use of propranolol and oxytocin can significantly reduce the cesarean section rate, shorten the duration of the latent phase and the duration of the active phase on day 1, and is safe. However, due to the limitations, the conclusions of this article still need to be verified by large-sample, multicenter, rigorously designed high-quality clinical RCTs.
Registration number is INPLASY202390107.
系统评价普萘洛尔联合催产素对分娩过程和结局的影响。
全面检索中国知网（CNKI）、维普、万方、中国生物医学文献数据库、PubMed、Embase 和 Cochrane 图书馆等多个数据库，收集普萘洛尔联合催产素与单独使用催产素比较用于分娩的随机对照试验（RCT）。筛选文献并提取数据后，使用 Cochrane 干预措施系统评价手册 5.1.0 推荐的偏倚风险评估工具评估纳入研究的质量。使用 RevMan 5.3 软件进行荟萃分析，并使用推荐分级评估、制定与评价（GRADE）系统对结局测量的证据质量进行评级。
Meta 分析结果显示，接受普萘洛尔联合催产素治疗的组剖宫产率更低（8 项研究，815 名女性，RR=0.67，95%CI（0.53，0.86），P=0.001），潜伏期（2 项研究，206 名女性，MD=−1.20，95%CI（−1.97，−0.43），P=0.002）和第 1 天活跃期（2 项研究，296 名女性，MD=−0.69，95%CI（−0.83，−0.54），P<0.00001）持续时间更短，与催产素单药治疗组相比。两组间 5 分钟 Apgar 评分（5 项研究，609 名女性，MD=−0.05，95%CI（−0.14，0.04），P=0.32）和新生儿重症监护病房（NICU）入住率（3 项研究，359 名女性，RR=0.82，95%CI（0.38，1.79），P=0.62）无显著差异。
普萘洛尔联合催产素的使用可显著降低剖宫产率，缩短潜伏期和第 1 天活跃期的持续时间，且安全。但由于存在局限性，本文结论仍需要大样本、多中心、严格设计的高质量临床 RCT 来验证。
注册号为 INPLASY202390107。
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