title: Neonatal effects of nifedipine and ritodrine for preterm labor.
abstract: OBJECTIVE
  We compared nifedipine and ritodrine for treatment of preterm labor with respect to neonatal outcome.
  
  
  METHODS
  We conducted an open randomized multicenter study of neonatal outcome in 185 women who received either oral nifedipine (n = 95) or intravenous (IV) ritodrine (n = 90) for treatment of preterm labor. Secondary outcome measures included neonatal mortality and morbidity, especially neonatal intensive care unit (NICU) admission, respiratory distress syndrome (RDS), and intracranial bleeding.
  
  
  RESULTS
  There were no significant differences in umbilical artery pH values and Apgar scores between groups. Nifedipine was associated with lower admission rates to the NICU (49% versus 66%; odds ratio 0. 51, confidence interval 0.28, 0.93) compared with ritodrine, and lower incidences of RDS (21% versus 37%; 0.46, 0.24, 0.89), intracranial bleeding (18% versus 31%; 0.48, 0.24, 0.96), and neonatal jaundice (52% versus 67%; 0.53, 0.29, 0.97). Logistic regression analysis showed that even after correction for gestational age at birth, newborn risk of RDS, intracranial bleeding, or neonatal jaundice was significantly lower in the nifedipine group than the ritodrine group.
  
  
  CONCLUSIONS
  Nifedipine for treatment of preterm labor was associated with a lower incidence of neonatal morbidity than ritodrine. That difference appeared to be partly because of the higher tocolytic efficacy of nifedipine and partly because of an intrinsic beneficial effect of nifedipine, or the lack of harmful effects when compared with ritodrine.
authors.affiliation: Department of Obstetrics and Gynecology, Free Universal Hospital Amsterdam, Academic Medical Center University of Amsterdam, The Netherlands.
authors.forename: D N
authors.initials: DN
authors.lastname: Papatsonis
authors.forename: J H
authors.initials: JH
authors.lastname: Kok
authors.forename: H P
authors.initials: HP
authors.lastname: van Geijn
authors.forename: O P
authors.initials: OP
authors.lastname: Bleker
authors.forename: H J
authors.initials: HJ
authors.lastname: Adèr
authors.forename: G A
authors.initials: GA
authors.lastname: Dekker
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009543:Nifedipine / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D012312:Ritodrine / Q000627:therapeutic use*; D015149:Tocolytic Agents / Q000627:therapeutic use*
chemical_list: D015149:Tocolytic Agents; D012312:Ritodrine; D009543:Nifedipine