{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:48:10Z","timestamp":1785422890491,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T00:00:00Z","timestamp":1471910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Preterm birth is the leading cause of neonatal mortality and morbidity in developed countries. Whether continued tocolysis after 48\u00a0hours of rescue tocolysis improves neonatal outcome is unproven.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the effectiveness of maintenance tocolytic therapy with oral nifedipine on the reduction of adverse neonatal outcomes and the prolongation of pregnancy by performing an individual patient data meta\u2010analysis (<jats:styled-content style=\"fixed-case\">IPDMA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>We searched PubMed, Embase, and Cochrane databases for randomised controlled trials of maintenance tocolysis therapy with nifedipine in preterm labour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>We selected trials including pregnant women between 24 and 36<jats:sup>6\/7<\/jats:sup>\u00a0weeks of gestation (gestational age, <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>) with imminent preterm labour who had not delivered after 48\u00a0hours of initial tocolysis, and compared maintenance nifedipine tocolysis with placebo\/no treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>The primary outcome was perinatal mortality. Secondary outcome measures were intraventricular haemorrhage (<jats:styled-content style=\"fixed-case\">IVH<\/jats:styled-content>), necrotising enterocolitis (<jats:styled-content style=\"fixed-case\">NEC<\/jats:styled-content>), infant respiratory distress syndrome (<jats:styled-content style=\"fixed-case\">IRDS<\/jats:styled-content>), prolongation of pregnancy, <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> at delivery, birthweight, neonatal intensive care unit admission, and number of days on ventilation support. Pre\u2010specified subgroup analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Six randomised controlled trials were included in this <jats:styled-content style=\"fixed-case\">IPDMA<\/jats:styled-content>, encompassing data from 787 patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a0390 for nifedipine; <jats:italic>n<\/jats:italic>\u00a0=\u00a0397 for placebo\/no treatment). There was no difference between the groups for the incidence of perinatal death (risk ratio, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a01.36; 95% confidence interval, 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.35\u20135.33), intraventricular haemorrhage (<jats:styled-content style=\"fixed-case\">IVH<\/jats:styled-content>)\u00a0\u2265\u00a0grade\u00a0<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a00.65; 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.16\u20132.67), necrotising enterocolitis (<jats:styled-content style=\"fixed-case\">NEC<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a01.15; 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.50\u20132.65), infant respiratory distress syndrome (<jats:styled-content style=\"fixed-case\">IRDS<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a00.98; 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.51\u20131.85), and prolongation of pregnancy (hazard ratio, <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a00.74; 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.55\u20131.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maintenance tocolysis is not associated with improved perinatal outcome and is therefore not recommended for routine practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Nifedipine maintenance tocolysis is not associated with improved perinatal outcome or pregnancy prolongation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14249","type":"journal-article","created":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T05:42:47Z","timestamp":1471930967000},"page":"1753-1760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Nifedipine maintenance tocolysis and perinatal outcome: an individual participant data meta\u2010analysis"],"prefix":"10.1111","volume":"123","author":[{"given":"EOG","family":"van Vliet","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GH","family":"Dijkema","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Schuit","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care University Medical Centre Utrecht Utrecht The Netherlands"},{"name":"Obstetrics and Gynaecology Academic Medical Centre Amsterdam The Netherlands"},{"name":"Department of Medicine Stanford Prevention Research Centre Stanford University Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KY","family":"Heida","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Roos","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JAM","family":"van der Post","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Academic Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EC","family":"Parry","sequence":"additional","affiliation":[{"name":"Consultant Maternal Fetal Medicine Service Auckland District Health Board Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"McCowan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology University Medical Centre Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DJ","family":"Lyell","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Stanford University Medical School Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YY","family":"El\u2010Sayed","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Stanford University Medical School Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DB","family":"Carr","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology University of Washington Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AL","family":"Clark","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology University of Washington Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ZA","family":"Mahdy","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology National University of Malaysia Medical Center Cheras Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Uma","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology National University of Malaysia Medical Center Cheras Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NC","family":"Sayin","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Trakya University Edime Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GF","family":"Varol","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Trakya University Edime Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BW","family":"Mol","sequence":"additional","affiliation":[{"name":"School of Paediatrics and Reproductive Health University of Adelaide Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MA","family":"Oudijk","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology University Medical Centre Utrecht Utrecht The Netherlands"},{"name":"Obstetrics and Gynaecology Academic Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2011.08.001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60820-4"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60074-4"},{"key":"e_1_2_7_5_1","first-page":"A5449","article-title":"The impact of a premature birth on the family; consequences are experienced even after 19\u00a0years","volume":"157","author":"Kusters CD","year":"2013","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12040"},{"issue":"19","key":"e_1_2_7_7_1","first-page":"CD004454","article-title":"Antenatal corticosteroids for accelerating foetal lung maturation for women at risk of preterm birth","author":"Roberts D","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.01135.x"},{"issue":"10","key":"e_1_2_7_9_1","first-page":"CD004071","article-title":"Maintenance therapy with calcium channel blockers for preventing preterm birth after threatened preterm labour","author":"Gaunekar NN","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c221"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1191\/1740774505cn087oa"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)70200-2"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00059.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_7_17_1","volume-title":"R: A language and environment for statistical computing","author":"Development Core Team R","year":"2012"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.153817"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70308-X"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818d8386"},{"key":"e_1_2_7_21_1","first-page":"35","article-title":"Maintenance nifedipine for tocolysis in preterm labour: a prospective randomised controlled trial","volume":"119","author":"Uma M","year":"2012","journal-title":"BJOG"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2004.041"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12179"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2011.12.003"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-011-0083-y"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.3.6.639"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01630.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90909-5"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.14249","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.14249","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.14249","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T05:32:52Z","timestamp":1696311172000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.14249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,23]]},"references-count":27,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/1471-0528.14249"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.14249","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,23]]},"assertion":[{"value":"2016-06-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}