Impact of a randomized trial on maintenance tocolysis on length of hospital admission of women with threatened preterm labor in The Netherlands.

Abstract

INTRODUCTION:

The APOSTEL-II trial was a multicenter randomized placebo-controlled trial, assessing the effectiveness of maintenance tocolysis with nifedipine. The trial showed maintenance tocolysis not to have an effect on perinatal outcome. Objective of the current study is to evaluate the effect of a negative trial on the length of hospital admission of women with threatened preterm labor.

MATERIALS AND METHODS:

We evaluated length of hospital admission of all patients admitted with threatened preterm labor with a gestational age <32 weeks in 8 perinatal centers that participated in the APOSTEL-II trial. We studied only the first admission with threatened preterm labor, readmissions were excluded. We distinguished between the period before, the period during and the period after the trial. In a subgroup analysis, we differentiated for the group of women who delivered and for the group of women who did not deliver during the initial admission.

RESULTS:

The mean length of hospital admission was 9.3 days before the start of the trial, 8.4 days during the recruitment period and 8.1 days after the trial was completed. The difference in mean length of hospital admission before and during the recruitment period was significantly different (p<001).

COMMENTS:

The length of hospital admission of women with threatened preterm labor is found to be reduced during the recruitment period of the APOSTEL-II trial. This shows that the conduct of a randomized controlled trial itself has the potential to change daily practice.

• Authors: Thomas S de Lange, Carolien Roos, Kitty W M Bloemenkamp, Antoinette C Bolte, Johannes J J Duvekot, Maureen T M Franssen, Marjolein Kok, Martijn A Oudijk, Martina M Porath, Joris A M van der Post, Ben Willem J Mol
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 186 Pg. 8-11 (Mar 2015) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 25596476 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Tocolytic Agents
• Nifedipine

Topics

• Female
• Gestational Age
• Humans
• Length of Stay (trends)
• Netherlands
• Nifedipine (therapeutic use)
• Obstetric Labor, Premature (prevention & control)
• Pregnancy
• Retrospective Studies
• Tocolytic Agents (therapeutic use)