What is known and objective: Premature birth affects more than 15 million infants, as well as mothers and families around the world. With the relaxation of the twochild policy, the problem of premature birth has become relatively prominent in China.According to statistics, China had a birth population of 15.23 million in 2018, with a considerably large number of premature births. This study aims to evaluate the efficacy and safety of tocolysis in the treatment of preterm delivery, provide clinical evidence for medical staff and promote the self-management of patients with premature births.Methods: Four English databases (PubMed, Embase, Cochrane Library and Web of Science) were retrieved by computer, the retrieval time was from the establishment of each database to November 2021, and the randomized controlled trials for the treatment of preterm delivery were screened according to the pre-set natriuretic exclusion criteria. After literature screening, data selection and risk of bias evaluation were independently conducted by two researchers. R 4.1.1 and Stata 17.0 software were used for statistical analysis.Results and discussion: A total of 44 RCTs were included, including 6939 patients.The results of network meta-analysis reveal that in terms of effectiveness, indomethacin was the most effective intervention measure, followed by nifedipine, and the difference was statistically significant; regarding safety, nifedipine was the safest intervention measure, followed by indomethacin, and the difference was statistically significant; and in respect of adverse reactions, ritodrine had the highest probability, and the difference was statistically significant.What is new and conclusion: Nifedipine may be better for delayed delivery and less likely to produce adverse pregnancy outcomes, followed by indomethacin. Limited by the number and quality of recipient studies, the aforementioned conclusions need to be verified through more high-quality studies. At the same time, the focus should be on patients with twin pregnancy and patients with clinical manifestations of extreme preterm delivery.
ObjectiveThe objective of this study was to systematically determine the benefits of Kangaroo-Mother Care (KMC) on the clinical outcomes of low birthweight (LBW) and preterm infants.MethodsFor this study, the following databases were retrieved for articles published until November 2021: PubMed, Web of Science, EBSCO, and the Cochrane library. The primary clinical outcome was mortality between enrollment and 28 days. The secondary clinical outcomes were the mean duration of hospital stay, hypothermia, sepsis, exclusive breastfeeding at the end of the neonatal period, and exclusive breastfeeding at discharge.ResultsWe conducted a meta-analysis, which included 17 RCTs, involving overall 17,668 participants. The results of this meta-analysis showed that KMC could reduce the primary clinical outcome of mortality between enrollment and 28 days (RR: 0.80, 95% Cl: 0.71–0.91, p < 0.01). For the secondary clinical outcomes, KMC had a varying degree of benefits on the mean duration of hospital stay (SMD: −0.96, 95% Cl: −1.02–0.90, p < 0.001), hypothermia (RR: 0.45, 95% Cl: 0.27–0.75, p < 0.01), and sepsis (RR: 0.79, 95% Cl: 0.70–0.89, p < 0.001). The exclusive breastfeeding at the end of the neonatal period and exclusive breastfeeding at discharge of KMC had benefits, which was not statistically different though (OR: 2.16, 95% Cl: 0.55–8.41, p = 0.27; OR: 1.16, 95% Cl: 0.82–1.64, p = 0.39, respectively).ConclusionsKMC was decreased mortality in LBW and premature infants between enrollment and 28 days. In addition, KMC also had a favorable effectiveness on the secondary clinical outcomes, such as mean duration of hospital stay, hypothermia, sepsis. Moreover, KMC also had a slight effectiveness on exclusive breastfeeding at the end of the neonatal period and exclusive breastfeeding at discharge.
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