Magazine article Science News

Treatment for Premature Labor Reevaluated

Magazine article Science News

Treatment for Premature Labor Reevaluated

Article excerpt

The drug ritodrine, widely used to prevent premature delivery, does not work in many cases, according to a large-scale study reported by Canadian researchers in the July 30 NEW ENGLAND JOURNAL OF MEDICINE.

Experts call for reduction of ritodrine treatments in light of potentially serious maternal side effects. "These results should greatly influence the treatment of preterm labor all over the world," concludes an editorial in the same journal by Kenneth J. Leveno and E Gary Cunningham, obstetricians at the University of Texas Southwestern Medical Center at Dallas.

Given to an estimated 100,000 U.S. women each year, ritodrine relaxes the muscles of the uterus and thus may temporarily halt preterm labor, says Lereno. The first randomized clinical trials of this drug took place in the early 1970s, but it was not approved for use in the United States until 1980. Developed for obstetrical use, ritodrine is the only drug specifically approved for treatment of preterm labor by the Food and Drug Administration.

But controversy has long surrounded its use, says Leveno, who believes the new findings confirm that ritodrine has few long-term benefits. In the largest ritodrine test yet conducted, researchers at six Canadian hospitals studied 708 women in danger of delivering their babies prematurely and followed 246 of their infants for 18 months. Each mother received randomly assigned treatment with either ritodrine or a placebo. Infants' gestational ages at the initiation of the study ranged from 20 to 35 weeks.

While ritodrine lowered the proportion of women who delivered within 24 to 48 hours after administration, it had no significant beneficial effects on the overall rates of premature delivery, low birth-weight, or infant mortality, the team reports. In addition, mothers given ritodrine showed an increase in serious side effects such as chest pain, irregular heart rhythms, and fluid-filled lungs. …

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