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Systematic review and meta‐analysis of randomized controlled trials of atosiban versus nifedipine for inhibition of preterm labor
Author(s) -
Ali Aya Ashraf,
Sayed Ahmed Kamal,
El Sherif Loalo'a,
Loutfi Gihan Ossam,
Ahmed Abdullah Mahmoud Mohamed,
Mohamed Hajer Bassem,
Anwar Ahmad Tareq,
Taha Abdullah Salah,
Yahia Reem Mohamed,
Elgebaly Ahmed,
AbdelDaim Mohamed M.
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12793
Subject(s) - medicine , nifedipine , tocolytic agent , randomized controlled trial , relative risk , meta analysis , confidence interval , pregnancy , anesthesia , obstetrics , preterm labor , fetus , biology , genetics , calcium
Background Two tocolytic drugs—atosiban and nifedipine—are currently used for first‐line treatment of preterm labor ( PTL ). Objective To compare the efficacy and safety of atosiban with nifedipine for PTL treatment. Search strategy In May 2017, we searched PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Clinical Trials with search terms including “nifedipine”, “atosiban”, and “preterm labor”. Selection criteria Randomized controlled trials of women with PTL . Data collection and analysis Data were extracted for study design, patient characteristics, risk of bias domains, and study outcomes. A random‐effects model was used to generate pooled risk ratios ( RR s) and 95% confidence intervals ( CI s). Results We included seven studies that enrolled 992 patients. There was no significant difference between atosiban and nifedipine for pregnancy prolongation of 48 hours or more regarding efficacy ( RR 1.06, 95% CI 0.92–1.22; P =0.440) or effectiveness (0.93, 0.84–1.03; P =0.177). Pregnancy prolongation for 7 days or more also did not differ between groups for efficacy ( RR 1.04, 95% CI 0.89–1.21; P =0.656) or effectiveness (0.91, 0.79–1.05; P =0.177). Atosiban‐however‐was associated with fewer maternal side‐effects than nifedipine. Conclusion Atosiban resulted in fewer maternal side‐effects than nifedipine, with no difference in pregnancy prolongation. PROSPERO registration: CRD 42018090223.