Secondary analysis of the use of transdermal nitroglycerin for preterm labor

Am J Obstet Gynecol. 2010 Dec;203(6):565.e1-6. doi: 10.1016/j.ajog.2010.07.018.

Abstract

Objective: This secondary analysis of a randomized placebo-controlled trial was to hypothesize on mechanisms for the improved neonatal outcomes with the use of nitroglycerin (GTN) for preterm labor.

Study design: Women in the original trial who delivered at term were excluded. A composite of severe neonatal outcomes, gestational age at delivery, and corticosteroid use in addition to Kaplan-Meier survival analysis to assess time from randomization to delivery were examined.

Results: A decrease in composite neonatal outcome (relative risk, 0.21; 95% confidence interval, 0.05-0.81; P = .018) with GTN (n = 39) compared with placebo (n = 38) was primarily due to a 23 day prolongation of pregnancy (P = .019) and a trend (P = .04) toward completing a course of corticosteroids in the subgroup randomized prior to 28 weeks' gestation.

Conclusion: We hypothesize that GTN has a gestational age-dependent reduction in neonatal outcomes as a result of pregnancy prolongation and corticosteroid administration.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Confidence Intervals
  • Delivery, Obstetric / methods
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Gestational Age*
  • Humans
  • Infant, Newborn
  • Maternal Age
  • Nitroglycerin / administration & dosage*
  • Obstetric Labor, Premature / drug therapy*
  • Obstetric Labor, Premature / prevention & control
  • Pregnancy
  • Pregnancy Outcome*
  • Reference Values
  • Term Birth*
  • Treatment Outcome
  • Young Adult

Substances

  • Nitroglycerin