Secondary analysis of the use of transdermal nitroglycerin for preterm labor

作者：Smith Graeme N^*; Guo Yanfang; Wen Shi Wu; Walker Mark C

来源：American Journal of Obstetrics and Gynecology, 2010, 203(6): 565.e1.

DOI：10.1016/j.ajog.2010.07.018

• morbidity
• pregnancy
• premature
• preterm labor
• tocolytic

OBJECTIVE: This secondary analysis of a randomized placebo-controlled trial was to hypothesize on mechanisms for the improved neonatal outcomes with the use of nitroglycerin (GTN) for preterm labor.
STUDY DESIGN: Women in the original trial who delivered at term were excluded. A composite of severe neonatal outcomes, gestational age at delivery, and corticosteroid use in addition to Kaplan-Meier survival analysis to assess time from randomization to delivery were examined.
RESULTS: A decrease in composite neonatal outcome (relative risk, 0.21; 95% confidence interval, 0.05-0.81; P = .018) with GTN (n = 39) compared with placebo (n = 38) was primarily due to a 23 day prolongation of pregnancy (P = .019) and a trend (P = .04) toward completing a course of corticosteroids in the subgroup randomized prior to 28 weeks' gestation.
CONCLUSION: We hypothesize that GTN has a gestational age-dependent reduction in neonatal outcomes as a result of pregnancy prolongation and corticosteroid administration.

• 出版日期2010-12