Preterm Labor Drug Poses More Problems Than Alternate Choice

Ivanhoe Newswire

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(Ivanhoe Newswire) -- A drug less commonly used to treat preterm labor may be a better option than the drug used more often for the condition.

A new study from Lucille Packard Children's Hospital and Stanford University School of Medicine has found magnesium sulfate is more likely than nifedipine to cause mild to serious side effects -- including vomiting, lethargy, and blurry vision -- in pregnant women. Because both drugs are similarly effective, researchers say doctors should consider side effects more strongly when deciding which drug to prescribe.

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Results also show newborns whose mothers took magnesium sulfate were more likely to be admitted to the neonatal intensive care unit than those whose mothers took nifedipine.

Preterm labor treatments like magnesium sulfate and nifedipine are thought to work by relaxing overactive uterine muscles and stopping cervical changes that may lead to delivery. It has not been previously clear if one is better than the others.

The study shows two-thirds of women who took magnesium sulfate had mild to severe side effects including shortness of breath and fluid build-up in the lungs during treatment. But only one-third of women who took nifedipine had any side effects, including headaches.

"The take-home message is that we saw no differences in relevant outcomes between the two groups," lead author Deirdre Lyell, M.D., Stanford University, was quoted as saying. "But there was a significant difference in the side effects experienced by the women, and some of these were very serious."

The authors stress magnesium sulfate is still appropriate for treating preterm labor. But they say it may be time for doctors to give more weight to the expected side effects when they are considering which treatment to try first.

This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.

SOURCE: Obstetrics & Gynecology, 2007;110:61-67