Cyclo-oxygenase (COX) inhibitors for preventing preterm labour

Department of Obstetrics and Gynaecology, Khon Kaen Hospital, Srichan Road, Khon Kaen, Thailand, 40000.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 10/2012; 10(10):CD007748. DOI: 10.1002/14651858.CD007748.pub2
Source: PubMed


Labour before full term in pregnancy can lead to preterm birth of the baby. Preterm labour describes frequent uterine contractions (at least four in 20 minutes or eight in 60 minutes) and progressive changes in the cervix. If preterm labour is not managed properly, active labour can occur and result in preterm birth, before 37 completed weeks' gestation. Preterm birth is the leading cause of low birthweight, illness and death for newborn babies. Substances called prostaglandins play an important role in the contraction of the muscle of the womb and are important during labour and birth. They are produced by cyclo-oxygenase (COX), which is an enzyme that increases the level of prostaglandins. Giving COX inhibitors to pregnant women at risk of preterm labour might stop contraction of the womb and allow them to reach full term. We included one small randomised trial (involving 98 women) that involved the drug rofecoxib, which is one type of COX inhibitor. The included study did not report any information about prevention of labour before full-term pregnancy. However, use of this COX inhibitor was associated with an increased risk of the baby being born before full term. We found insufficient data to make any recommendation about using COX inhibitors for preventing preterm labour. Future research should include the follow-up of babies to examine the short- and longer-term effects associated with using COX inhibitors during pregnancy.

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