[Clinical efficacy and perinatal outcome of nifedipine for severe preeclampsia: meta-analysis].

Abstract

OBJECTIVE:

To assess the efficacy, side effects and perinatal outcome of nifedipine compared with other antihypertensives for treating severe preeclampsia in pregnant women.

METHODS:

Randomized controlled trials (RCTs) that comparing nifedipine with other antihypertensives for severe preeclampsia were searched in PubMed, EMBase, Cochrane library, CNKI and VIP database etc(till January 2012). The quality of the included RCTs was evaluated, and Meta-analysis was performed with Rev Man 5.1 software.

RESULTS:

Nine trials were included, involving 386 women in the nifedipine group, and 378 women in other antihypertensives group. Compared with other antihypertensives, nifidepine was associated with greater effective control of blood pressure (OR = 2.65, 95%CI: 1.65 - 4.25, P < 0.01). There was no clear difference in the time needed to control blood pressure (WMD = -3.64, 95%CI: -10.90 - 3.61, P = 0.32). Nifedipine could prolong gestation better than other antihypertensives (WMD = 5.14, 95%CI: 3.29 - 6.99, P < 0.01). There were no clear differences in maternal side effects headache (P = 0.28), palpitation (P = 0.06), and nausea vomiting (P = 0.28). No noticeable difference was found between the two groups in the Apgar score at five minutes (WMD = -0.21, 95%CI: -0.32 - 0.91, P = 0.72), neonatal respiratory distress syndrome (OR = 1.24, 95%CI: 0.57 - 2.67, P = 0.59), or perinatal deaths (OR = 0.49, 95%CI: 0.22 - 1.11, P = 0.09).

CONCLUSION:

Nifedipine is associated with greater effective control of blood pressure and prolongation of gestation, with no additional neonatal respiratory distress syndrome or perinatal deaths, compared with other antihypertensives for women with severe preeclampsia.

• Authors: Qian-qian Liu, Yan-hong Yu, Shi-peng Gong, Li-ping Huang
• Journal: Zhonghua fu chan ke za zhi (Zhonghua Fu Chan Ke Za Zhi) Vol. 47 Issue 8 Pg. 592-7 (Aug 2012) ISSN: 0529-567X [Print] China
• PMID: 23141179 (Publication Type: English Abstract, Journal Article, Meta-Analysis)

Chemical References

• Antihypertensive Agents
• Hydralazine
• Nifedipine
• Labetalol

Topics

• Antihypertensive Agents (adverse effects, therapeutic use)
• Blood Pressure (drug effects)
• Female
• Humans
• Hydralazine (adverse effects, therapeutic use)
• Hypertension (drug therapy)
• Infant, Newborn
• Labetalol (adverse effects, therapeutic use)
• Nifedipine (adverse effects, therapeutic use)
• Perinatal Mortality
• Pre-Eclampsia (drug therapy)
• Pregnancy
• Pregnancy Outcome
• Respiratory Distress Syndrome, Newborn (epidemiology, etiology)
• Severity of Illness Index