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A groundbreaking study led by Amsterdam UMC has revealed that the use of tocolytic drugs to delay premature birth after 30 weeks of pregnancy does not provide any health benefits to the baby. The findings, published in The Lancet, challenge long-standing medical practices surrounding the treatment of threatened premature labor (TPL).
Rethinking Tocolytic Drug Use
Premature birth affects one in 10 pregnancies worldwide, leading to increased risks of mortality and serious health complications for newborns. Tocolytic drugs have traditionally been used to postpone delivery, under the assumption that extending pregnancy allows for further fetal development, reducing associated risks.
However, according to Professor Martijn Oudijk of Amsterdam UMC, prior to this study, no research had definitively proven whether the prolongation of pregnancy via tocolytics actually benefited newborns.
The Largest Study of Its Kind
The research, conducted in 24 Dutch hospitals and two additional hospitals in England and Ireland, included 755 women experiencing TPL between 30 and 34 weeks of gestation. Participants were randomly assigned to receive either a tocolytic drug or a placebo.
Larissa van der Windt, a Ph.D. student at Amsterdam UMC, emphasized the significance of the study: “This is the largest placebo-controlled study ever conducted on the effects of tocolytic drugs on neonatal health. Our results showed no difference whatsoever—there was no benefit, but also no harm.”
Implications for Medical Practice
These findings suggest the need for a reassessment of current medical protocols. “We must reconsider whether tocolytic drugs should remain a standard treatment for TPL after 30 weeks,” said Oudijk. “Premature birth often results from medical conditions like infections or placental problems, meaning that prolonging pregnancy in these cases might even be detrimental.”
In countries such as Canada and Ireland, hospitals have already stopped administering tocolytic drugs after 30 weeks. Oudijk stresses the urgency of revising international guidelines to reflect this new evidence.
The full study, titled Atosiban versus placebo for threatened preterm birth (APOSTEL 8): a multicentre, randomised-controlled trial, is available in The Lancet.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Patients should consult their healthcare providers for guidance on treatment options related to premature labor and pregnancy care.
