Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour (Cochrane Review)
Magnesium does not reduce preterm birth or improve the outcome for the infant when given to women after contractions of preterm labour have been stopped. Babies born preterm, before 37 weeks of pregnancy, may not survive or they may have later physical health and developmental problems if they do survive. Women whose preterm labour is stopped with tocolytic therapy (medication to reduce uterine contractions) remain at high risk of preterm birth. A variety of agents (tocolytics) are used to halt the uterine contractions. These include betamimetics, calcium channel blockers, magnesium sulphate, and oxytocin receptor antagonists. Subsequent tocolytic maintenance medication has been advocated. Oral and intravenous magnesium has been used to prevent further early contractions. We included four randomised controlled trials involving a total of 422 women in this review. The trials did not demonstrate any differences between magnesium maintenance therapy and placebo or other treatments (ritodrine or terbutaline) in the prevention of preterm birth or perinatal deaths. The trials were too small to exclude either important benefits or harms from magnesium maintenance therapy. Magnesium was less likely than the alternative tocolytics (betamimetics) to result in side effects, particularly palpitations or tachycardia, although diarrhoea was more likely. This finding is based on very few studies of low quality, and none of them looked at the infants' later development.
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