Author(s):
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Vliet, E. van; Seinen, L.; Roos, C.; Schuit, E.; Scheepers, H.; Bloemenkamp, K.; Duvekot, J.J.; Eyck, J. van; Kok, J.H.;
Lotgering, F.K.
; Baar, A. van; Wassenaer-Leemhuis, A.G. van; Franssen, M.T.; Porath, M.M.; Post, J. van der; Franx, A.; Mol, B.; Oudijk, M.A.
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Subject:
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Radboudumc 17: Women's cancers RIHS: Radboud Institute for Health Sciences Radboudumc 5: Inflammatory diseases RIHS: Radboud Institute for Health Sciences |
Journal title:
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Bjog : an International Journal of Obstetrics and Gynaecology
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Abstract:
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OBJECTIVE: To evaluate long-term effects of maintenance tocolysis with nifedipine on neurodevelopmental outcome of the infant. DESIGN, SETTING AND POPULATION: Follow up of infants of women who participated in a multicentre randomised controlled trial on maintenance tocolysis with nifedipine versus placebo. METHODS: Two years after the APOSTEL II trial on maintenance tocolysis with nifedipine versus placebo, we asked participants to complete the Ages and Stages Questionnaire. MAIN OUTCOME MEASURES: Infant development was measured in five domains. Developmental delay was defined as a score of </=1 SD in one or more developmental domains. We performed exploratory subgroup analysis in women with preterm prolonged rupture of the membranes, and in women with a cervical length <10 mm at study entry. RESULTS: Of the 276 women eligible for follow up, 135 (52.5%) returned the questionnaire, encompassing data of 170 infants. At 2 years of age, infants of women with nifedipine maintenance tocolysis compared with placebo had a higher overall incidence of fine motor problems (22.2 versus 7.6%, OR 3.43, 95% CI 1.29-9.14, P = 0.01), and a lower incidence of poor problem-solving (21.1 versus 29.1%, OR 0.27, 95% CI 0.08-0.95, P = 0.04). CONCLUSIONS: This follow-up study revealed no clear benefit of nifedipine maintenance tocolysis at 2 years of age. As short-term adverse perinatal outcome was not reduced in the original APOSTEL II trial, we conclude that maintenance tocolysis does not appear to be beneficial at this time. TWEETABLE ABSTRACT: No clear benefit of nifedipine maintenance tocolysis in preterm labour on 2-year infant outcome.
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