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Calcium channel blockers for inhibiting preterm labour and birth

  1. Vicki Flenady1,*,
  2. Aleena M Wojcieszek1,
  3. Dimitri NM Papatsonis2,
  4. Owen M Stock3,
  5. Linda Murray4,
  6. Luke A Jardine5,
  7. Bruno Carbonne6

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 5 JUN 2014

Assessed as up-to-date: 12 NOV 2013

DOI: 10.1002/14651858.CD002255.pub2


How to Cite

Flenady V, Wojcieszek AM, Papatsonis DNM, Stock OM, Murray L, Jardine LA, Carbonne B. Calcium channel blockers for inhibiting preterm labour and birth. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD002255. DOI: 10.1002/14651858.CD002255.pub2.

Author Information

  1. 1

    Mater Research Institute - The University of Queensland (MRI-UQ), Translating Research Into Practice (TRIP) Centre, Brisbane, Queensland, Australia

  2. 2

    Amphia Hospital Breda, Department of Obstetrics and Gynaecology, Breda, Netherlands

  3. 3

    Mater Mothers' Hospital, Mater Health Services, Department of Obstetrics and Gynaecology, Brisbane, Queensland, Australia

  4. 4

    University of Tasmania, School of Medicine, Hobart, Australia

  5. 5

    Mater Mothers' Hospital, Mater Medical Research Institute, The University of Queensland, Department of Neonatology, South Brisbane, Queensland, Australia

  6. 6

    Hopital Trousseau, Department of Obstetrics and Gynecology, Paris, Paris, France

*Vicki Flenady, Translating Research Into Practice (TRIP) Centre, Mater Research Institute - The University of Queensland (MRI-UQ), Level 2 Aubigny Place, Mater Health Services, Annerley Road, Woolloongabba, Brisbane, Queensland, 4102, Australia. vflenady@mmri.mater.org.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 5 JUN 2014

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[Figure 1]
Figure 1. 'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 2]
Figure 2. 'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
[Figure 3]
Figure 3. Funnel plot of comparison: 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), outcome: 2.1 Birth less than 48 hours after trial entry.
[Figure 4]
Figure 4. Funnel plot of comparison: 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by agent), outcome: 2.3 Perinatal mortality.
[Figure 5]
Figure 5. Funnel plot of comparison: 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), outcome: 2.9 Preterm birth (before completion of 37 weeks of gestation).
[Analysis 1.1]
Analysis 1.1. Comparison 1 Calcium channel blockers compared with placebo or no treatment, Outcome 1 Birth within 48 hours after trial entry.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Calcium channel blockers compared with placebo or no treatment, Outcome 2 Preterm birth (before completion of 37 weeks of gestation).
[Analysis 1.3]
Analysis 1.3. Comparison 1 Calcium channel blockers compared with placebo or no treatment, Outcome 3 Maternal adverse effects.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 1 Birth less than 48 hours after trial entry.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 2 Very preterm birth (before completion of 34 weeks of gestation).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 3 Perinatal mortality (stillbirth and neonatal death up to 28 days).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 4 Stillbirth.
[Analysis 2.5]
Analysis 2.5. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 5 Neonatal death.
[Analysis 2.6]
Analysis 2.6. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 6 Maternal death.
[Analysis 2.7]
Analysis 2.7. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 7 Interval between trial entry and birth (days).
[Analysis 2.8]
Analysis 2.8. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 8 Gestational age at birth (completed weeks).
[Analysis 2.9]
Analysis 2.9. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 9 Preterm birth (before completion of 37 weeks of gestation).
[Analysis 2.10]
Analysis 2.10. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 10 Extremely preterm birth (before completion of 28 weeks of gestation).
[Analysis 2.11]
Analysis 2.11. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 11 Apgar score < 7 at 5 minutes.
[Analysis 2.12]
Analysis 2.12. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 12 Admission to NICU.
[Analysis 2.13]
Analysis 2.13. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 13 Respiratory distress syndrome.
[Analysis 2.14]
Analysis 2.14. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 14 Chronic lung disease.
[Analysis 2.15]
Analysis 2.15. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 15 Necrotising enterocolitis.
[Analysis 2.16]
Analysis 2.16. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 16 Neonatal sepsis.
[Analysis 2.17]
Analysis 2.17. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 17 Neonatal jaundice.
[Analysis 2.18]
Analysis 2.18. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 18 Intraventricular haemorrhage.
[Analysis 2.19]
Analysis 2.19. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 19 Intraventricular haemorrhage grades 3 or 4.
[Analysis 2.20]
Analysis 2.20. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 20 Periventricular leukomalacia (PVL).
[Analysis 2.21]
Analysis 2.21. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 21 Retinopathy of prematurity.
[Analysis 2.22]
Analysis 2.22. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 22 Maternal adverse effects.
[Analysis 2.23]
Analysis 2.23. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 23 Discontinuation of therapy for maternal adverse effects.
[Analysis 2.24]
Analysis 2.24. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 24 Caesarean section.
[Analysis 2.25]
Analysis 2.25. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 25 Duration of stay in NICU (days).
[Analysis 2.26]
Analysis 2.26. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 26 Duration of maternal hospital stay (days).
[Analysis 2.27]
Analysis 2.27. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 27 Behavioural-emotional problems at 9-12 years.
[Analysis 2.28]
Analysis 2.28. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 28 Special education at 9-12 years.
[Analysis 2.29]
Analysis 2.29. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 29 Motor quality at 9-12 years.
[Analysis 2.30]
Analysis 2.30. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 30 Quality of life at 9-12 years: physical.
[Analysis 2.31]
Analysis 2.31. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 31 Quality of life at 9-12 years: motor.
[Analysis 2.32]
Analysis 2.32. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 32 Quality of life at 9-12 years: autonomy.
[Analysis 2.33]
Analysis 2.33. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 33 Quality of life at 9-12 years: cognitive.
[Analysis 2.34]
Analysis 2.34. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 34 Quality of life at 9-12 years: social.
[Analysis 2.35]
Analysis 2.35. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 35 Quality of life at 9-12 years: positive emotion.
[Analysis 2.36]
Analysis 2.36. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 36 Quality of life at 9-12 years: negative emotion.
[Analysis 2.37]
Analysis 2.37. Comparison 2 Calcium channel blockers compared with any other tocolytic agent (subgrouped by other tocolytic), Outcome 37 Parent distress scores at 9-12 years.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Calcium channel blockers compared with betamimetics (subgrouped by type of CCB), Outcome 1 Birth within 48 hours after trial entry.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Calcium channel blockers compared with betamimetics (subgrouped by type of CCB), Outcome 2 Very preterm birth (before completion of 34 weeks of gestation).
[Analysis 3.3]
Analysis 3.3. Comparison 3 Calcium channel blockers compared with betamimetics (subgrouped by type of CCB), Outcome 3 Perinatal mortality (fetal death and neonatal death up to 28 days).
[Analysis 3.4]
Analysis 3.4. Comparison 3 Calcium channel blockers compared with betamimetics (subgrouped by type of CCB), Outcome 4 Interval between trial entry and birth (days).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Calcium channel blockers compared with betamimetics (subgrouped by type of CCB), Outcome 5 Respiratory distress syndrome.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Calcium channel blockers compared with betamimetics (subgrouped by type of CCB), Outcome 6 Discontinuation of therapy for maternal adverse effects.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Calcium channel blockers compared with magnesium sulphate (subgrouped by type of CCB), Outcome 1 Birth within 48 hours after trial entry.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Calcium channel blockers compared with magnesium sulphate (subgrouped by type of CCB), Outcome 2 Very preterm birth (before completion of 34 weeks of gestation).
[Analysis 4.3]
Analysis 4.3. Comparison 4 Calcium channel blockers compared with magnesium sulphate (subgrouped by type of CCB), Outcome 3 Perinatal mortality (fetal death and neonatal death up to 28 days).
[Analysis 4.4]
Analysis 4.4. Comparison 4 Calcium channel blockers compared with magnesium sulphate (subgrouped by type of CCB), Outcome 4 Maternal death.
[Analysis 4.5]
Analysis 4.5. Comparison 4 Calcium channel blockers compared with magnesium sulphate (subgrouped by type of CCB), Outcome 5 Interval between trial entry and birth (days).
[Analysis 4.6]
Analysis 4.6. Comparison 4 Calcium channel blockers compared with magnesium sulphate (subgrouped by type of CCB), Outcome 6 Respiratory distress syndrome.
[Analysis 4.7]
Analysis 4.7. Comparison 4 Calcium channel blockers compared with magnesium sulphate (subgrouped by type of CCB), Outcome 7 Discontinuation of therapy for maternal adverse effects.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 1 Birth within 48 hours after trial entry.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 2 Very preterm birth (before completion of 34 weeks of gestation).
[Analysis 5.3]
Analysis 5.3. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 3 Extremely preterm birth (before completion of 28 weeks of gestation).
[Analysis 5.4]
Analysis 5.4. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 4 Perinatal mortality (stillbirth and neonatal death up to 28 days).
[Analysis 5.5]
Analysis 5.5. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 5 Stillbirth.
[Analysis 5.6]
Analysis 5.6. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 6 Neonatal death.
[Analysis 5.7]
Analysis 5.7. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 7 Maternal death.
[Analysis 5.8]
Analysis 5.8. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 8 Interval between trial entry and birth (days).
[Analysis 5.9]
Analysis 5.9. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 9 Gestational age at birth (completed weeks).
[Analysis 5.10]
Analysis 5.10. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 10 Preterm birth (before completion of 37 weeks of gestation).
[Analysis 5.11]
Analysis 5.11. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 11 Apgar score < 7 at 5 minutes.
[Analysis 5.12]
Analysis 5.12. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 12 Admission to NICU.
[Analysis 5.13]
Analysis 5.13. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 13 Respiratory distress syndrome.
[Analysis 5.14]
Analysis 5.14. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 14 Necrotising enterocolitis.
[Analysis 5.15]
Analysis 5.15. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 15 Neonatal sepsis.
[Analysis 5.16]
Analysis 5.16. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 16 Neonatal jaundice.
[Analysis 5.17]
Analysis 5.17. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 17 Intraventricular haemorrhage.
[Analysis 5.18]
Analysis 5.18. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 18 Maternal adverse effects.
[Analysis 5.19]
Analysis 5.19. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 19 Discontinuation of therapy for maternal adverse effects.
[Analysis 5.20]
Analysis 5.20. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 20 Duration of stay in NICU (days).
[Analysis 5.21]
Analysis 5.21. Comparison 5 Higher dose calcium channel blockers compared with lower dose calcium channel blockers, Outcome 21 Duration of maternal hospital stay (days).