| Autor: |
de Souza ATB; Postgraduate Program in Sciences Applied to Women's Health, Januário Cicco Maternity School, Federal University of Rio Grande do Norte, Natal, Brazil., de Lima Machado ML; Postgraduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil., Sarmento ACA; Postgraduate Program in Health Sciences, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.; Department of Clinical and Toxicological Analysis, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil., Costa APF; Postgraduate Program in Health Sciences, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.; Research and Innovation Teaching Institute, League Against Cancer, Natal, Brazil., Costa TXD; Januário Cicco Maternity School, Federal University of Rio Grande do Norte, Natal, Brazil., de Medeiros KS; Postgraduate Program in Health Sciences, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.; Research and Innovation Teaching Institute, League Against Cancer, Natal, Brazil., Vale AJM; Department of Tocogynecology, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.; Postgraduate Program of Biotechnology, Potiguar University, Natal, Brazil., Cobucci RN; Postgraduate Program in Sciences Applied to Women's Health, Januário Cicco Maternity School, Federal University of Rio Grande do Norte, Natal, Brazil.; Januário Cicco Maternity School, Federal University of Rio Grande do Norte, Natal, Brazil.; Postgraduate Program of Biotechnology, Potiguar University, Natal, Brazil., Martins RR; Postgraduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.; Postgraduate Program in Pharmaceutical Services and Policies, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil. |
| Abstrakt: |
Preterm labor, defined as contractions occurring every 5-10 minutes with cervical changes before the 37th week of estimated gestation, is a significant cause of perinatal mortality. This meta-analysis aims to evaluate the effectiveness and safety of magnesium sulfate compared to nifedipine in managing preterm labor. The systematic review protocol was registered with PROSPERO (CRD42023422419). Manuscripts published up to September 2024 were systematically searched in databases. Dichotomous data were pooled as odds ratios using a random-effects model with the Mantel-Haenszel method, while continuous data were analyzed as mean ± standard deviation values, mean differences, and standardized mean differences using inverse-variance fixed-effects analysis. Fifteen randomized clinical trials (RCTs) were included, enrolling a total of 2,186 pregnant women. Nifedipine showed a greater effect compared to a 4-gram IV dose of magnesium sulfate. However, the efficacy of these tocolytics in prolonging pregnancy by 48 hours did not significantly differ between nifedipine and a 6-gram IV dose of magnesium sulfate. Additionally, magnesium sulfate was associated with more adverse drug reactions. The moderate certainty of evidence found here requires confirmation in large, adequately powered RCTs. |
