Nifedipine in the management of preterm labor: a systematic review and metaanalysis

Am J Obstet Gynecol. 2011 Feb;204(2):134.e1-20. doi: 10.1016/j.ajog.2010.11.038.


Objective: To determine the efficacy and safety of nifedipine as a tocolytic agent in women with preterm labor.

Study design: A systematic review and metaanalysis of randomized controlled trials.

Results: Twenty-six trials (2179 women) were included. Nifedipine was associated with a significant reduction in the risk of delivery within 7 days of initiation of treatment and before 34 weeks' gestation, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, neonatal jaundice, and admission to the neonatal intensive care unit when compared with β₂-adrenergic-receptor agonists. There was no difference between nifedipine and magnesium sulfate in tocolytic efficacy. Nifedipine was associated with significantly fewer maternal adverse events than β₂-adrenergic-receptor agonists and magnesium sulfate. Maintenance nifedipine tocolysis was ineffective in prolonging gestation or improving neonatal outcomes when compared with placebo or no treatment.

Conclusion: Nifedipine is superior to β₂-adrenergic-receptor agonists and magnesium sulfate for tocolysis in women with preterm labor.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Intramural
  • Review
  • Systematic Review

MeSH terms

  • Adrenergic beta-2 Receptor Agonists / therapeutic use
  • Female
  • Humans
  • Magnesium Sulfate / therapeutic use
  • Nifedipine / therapeutic use*
  • Obstetric Labor, Premature / drug therapy*
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Tocolytic Agents / therapeutic use
  • Treatment Outcome


  • Adrenergic beta-2 Receptor Agonists
  • Tocolytic Agents
  • Magnesium Sulfate
  • Nifedipine