Tocolytic Therapy for Preterm Labor: Two Days Are All You Get

Prematurity is a leading cause of pediatric morbidity and death, yet few interventions have proved efficacious in limiting its prevalence. Most tocolytic agents delay delivery for only 48 hours (long enough to allow administration of antenatal corticosteroids). Although the majority of studies have failed to show a benefit from continuing tocolysis beyond this point, no trial has been large enough to permit evaluation of neonatal outcomes. Investigators in the Netherlands randomized 406 women with threatened preterm birth to an additional 12 days of nifedipine or placebo after completion of a 48-hour initial course of tocolysis. Adverse perinatal outcomes (a composite measure of many serious neonatal morbidities) were assessed.

The probabili…