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Magnesiummaintenancetherapyforpreventingpreterm
birth after threatened preterm labour (Review)
Crowther CA, MooreV
ThisisareprintofaCochranereview,preparedandmaintained byTheCochraneCollaborationandpublishedinTheCochraneLibrary
2007, Issue 2
http://www.thecochranelibrary.com
Magnesiummaintenancetherapy forpreventingpreterm birth after threatened preterm labour (Review) 1
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
TABLE OF CONTENTS
ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
PLAINLANGUAGESUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
CRITERIAFORCONSIDERINGSTUDIESFORTHISREVIEW . . . . . . . . . . . . . . . . . . 2
SEARCHMETHODSFORIDENTIFICATIONOFSTUDIES . . . . . . . . . . . . . . . . . . . 2
METHODSOFTHEREVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DESCRIPTIONOFSTUDIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
METHODOLOGICALQUALITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
AUTHORS’CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
NOTES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
POTENTIALCONFLICTOFINTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
SOURCESOFSUPPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Characteristics of included studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Characteristics of excluded studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ANALYSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Comparison 01. Magnesium maintenance therapy versus placebo or no treatment . . . . . . . . . . . . 8
Comparison 02. Magnesium maintenance therapy versus alternative treatment . . . . . . . . . . . . . 9
INDEXTERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
COVERSHEET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
GRAPHSANDOTHERTABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Analysis 01.01. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 01 10
Gestational age at delivery (weeks) . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.02. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 02 Pre-term 11
birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.03. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 03 Perinatal 12
mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.05. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 05 Maternal 12
readmission for threatened preterm labour . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.07. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 07 13
Respiratory distress syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.09. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 09 13
Periventricular haemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.11. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 11 Maternal 14
side-effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.12. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 12 Mother’s 15
perception of therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.13. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 13 Neonatal 16
intensive care unit admissions . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 01.14. Comparison 01 Magnesium maintenance therapy versus placebo or no treatment, Outcome 14 Neonatal 16
length of stay (days) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.01. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 01 Gestational 17
age at delivery (weeks) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.02. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 02 Preterm 17
birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Magnesiummaintenancetherapy forpreventingpreterm birth after threatened preterm labour (Review) i
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
Analysis 02.03. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 03 Perinatal 18
mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.05. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 05 Maternal 19
readmission for threatened preterm labour . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.09. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 09 19
Periventricular haemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.11. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 11 Maternal 20
side-effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.12. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 12 Mother’s 22
perception of therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.13. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 13 Neonatal 22
intensive care unit admissions . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Analysis 02.14. Comparison 02 Magnesium maintenance therapy versus alternative treatment, Outcome 14 Neonatal 23
length of stay (days) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Magnesiummaintenancetherapy forpreventingpreterm birth after threatened preterm labour (Review) ii
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
Magnesiummaintenancetherapyforpreventingpreterm
birth after threatened preterm labour (Review)
Crowther CA, Moore V
This record should be cited as:
Crowther CA, Moore V. Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour. Cochrane
Database of Systematic Reviews 1998, Issue 1. Art. No.: CD000940. DOI: 10.1002/14651858.CD000940.
This version first published online: 26 January 1998 in Issue 1, 1998.
Date of most recent substantive amendment: 19 November 1997
ABSTRACT
Background
Magnesiummaintenancetherapyisoneofthetypesoftocolytictherapyusedafteranepisodeofthreatenedpretermlabour(andusually
an initial dose of tocolytic therapy) in an attempt to prevent the onset of further preterm contractions.
Objectives
To assess the effects of magnesium maintenance therapy on preventing preterm birth after threatened preterm labour.
Search strategy
WesearchedtheCochrane Pregnancy and Childbirth Group trials register (August 2002).
Selection criteria
Randomised controlled trials of magnesium therapy given to women after threatened preterm labour.
Data collection and analysis
Trial quality assessment and data extraction were done independently by two reviewers.
Main results
Three trials, which recruited 303 women, were included. Two trials were of poor quality 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 relative risk (RR) for preterm birth
(less than 37 weeks) for magnesium compared with placebo or no treatment was 0.85, 95% confidence interval (CI) 0.47 to 1.51;
and 0.98, 95% CI 0.56 to 1.72 for magnesium compared with alternative therapies. The RR for perinatal mortality for magnesium
compared with placebo or no treatment, and also compared with alternative treatments, was 5.00, 95% CI 0.25 to 99.16. Women
taking magnesium preparations were less likely to report palpitations or tachycardia than women receiving alternative therapies (RR
0.22, 95% CI 0.11 to 0.44) but were much more likely to experience diarrhoea (RR 10.67, 95% CI 3.35 to 33.99).
Authors’ conclusions
Thereis not enough evidence to show any difference between magnesium maintenance therapy and either placebo or no treatment, or
alternative therapies (ritodrine or terbutaline) in preventing preterm birth after an episode of threatened preterm labour.
PLAIN LANGUAGE SUMMARY
Magnesium, given to women after threatening to give birth too early, does not reduce preterm birth or improve the outcome for the
infant
Babies born prematurely may not survive, or may have later problems if they do survive. After other drugs have been used to try to
stop early labour, magnesium is used to prevent further early contractions. This review did not show that magnesium used in this way
helpedprevent preterm birth, but this finding is based on very few studies, and none of them looked at the infants’ later development.
Magnesiummaintenancetherapy forpreventingpreterm birth after threatened preterm labour (Review) 1
Copyright©2007 The CochraneCollaboration.Published byJohn Wiley & Sons, Ltd
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