The certainty of evidence is downgraded by indirectness of evidence.
A Cochrane review and network meta-analysis[Abstract] 1assessing different tocolytic drugs included 122 trials with a total of 13 697 women (table T1). Nitric oxide donors ranked highest for delaying preterm birth by 48 hours and 7 days followed by calcium channel blockers, oxytocin receptor antagonists and combinations of tocolytics. In direct comparison with placebo or no treatment nitric oxide donors showed a trend towards benefit (RR 1.18, 955 CI 0.76 to 1.84, low evidence).
| Outcome | Network evidence | Anticipated absolute effects for network estimate | ||
|---|---|---|---|---|
| RR (95% CI) Certainty | Risk with placebo or no treatment | Risk with tocolytic agent | Risk difference with tocolytic agent | |
| Betamimetics | 1.12(1.05 to 1.20) Low | 645 per 1000 | 722 per 1000 | 77 more per 1000(from 32 to 129 more) |
| Calcium channel blockers | 1.16(1.07 to 1.24)Low | 645 per 1000 | 748 per 1000 | 103 per 1000(from 45 to 155 more) |
| Magnesium sulphate | 1.12(1.02 to 1.23) Moderate | 645 per 1000 | 722 per 1000 | 77 more per 1000(from 13 to 148 more) |
| Oxytocin receptor antagonists | 1.13(1.05 to 1.22) Moderate | 645 per 1000 | 729 per 1000 | 84 more per 1000(from 32 to 142 more) |
| Nitric oxide donors | 1.17(1.05 to 1.31) Moderate | 645 per 1000 | 755 per 1000 | 110 per 1000(from 32 to 200 more) |
Date of latest search: 2022-11-08
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