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Clinical efficacy and perinatal outcome of nifedipine for severe preeclampsia: Meta-analysis

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Author:
No author available
Journal Title:
Chinese Journal of Obstetrics and Gynecology
Issue:
8
DOI:
10.3760/cma.j.issn.0529-567x.2012.08.008
Key Word:
硝苯地平;抗高血压药;先兆子痫;妊娠结局;Meta分析;Nifedipine;Antihypertensive agents;Pre-eclampsia;Pregnancy outcome;Meta-analysis

Abstract: Objective To assess the efficacy,side effects and perinatal outcome of nifedipine compared with other antihypertensives for treating severe preeclampsia in pregnant women. Methods Randomized controlled trials (RCTs) that comparing nifedipine with other antihypertensives for severe preeclampsia were searched in PubMed,EMBase,Cochrane library,CNKI and VIP database etc( till January 2012).The quality of the included RCTs was evaluated,and Meta-analvsis was performed with Rev Man 5.1software.Results Nine trials were included,involving 386 women in the nifedipine group,and 378 women in other antihypertensives group.Compared with other antihypertensives,nifidepine was associated with greater effective control of blood pressure ( OR =2.65,95% CI:1.65 -4.25,P <0.01 ).There was no clear difference in the time needed to control blood pressure ( W.M D =- 3.64,95% CI:- 10.90 - 3.61,P =0.32 ).Nifedipine could prolong gestation better than other antihypertensives ( WMD =5.14,95% CI:3.29-6.99,P <0.01 ).There were no clear differences in maternal side effects headache (P =0.28),palpitation ( P =0.06 ),and nausea vomiting ( P =0.28 ).No noticeable difference was found between the two groups in the Apgar score at five minutes ( WMD =- 0.21,95% CI:- 0.32 - 0.91,P =0.72),neonatal respiratory distress syndrome ( OR =1.24,95% CI:0.57 - 2.67,P =0.59 ),or perinatal deaths ( OR =0.49,95% CI:0.22 - 1.11,P =0.09 ).Conclusion Nifedipine is associated with greater effective control of blood pressure and prolongation of gestation,with no additional neonatal respiratory distress syndrome or perinatal deaths,compared with other antihypertensives for women with severe preeclampsia.

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