title: Impact of a randomized trial on maintenance tocolysis on length of hospital admission of women with threatened preterm labor in The Netherlands.
abstract: BACKGROUND
  The APOSTEL-II trial was a multicenter randomized placebo-controlled trial, assessing the effectiveness of maintenance tocolysis with nifedipine. The trial showed maintenance tocolysis not to have an effect on perinatal outcome. Objective of the current study is to evaluate the effect of a negative trial on the length of hospital admission of women with threatened preterm labor.
  
  
  METHODS
  We evaluated length of hospital admission of all patients admitted with threatened preterm labor with a gestational age <32 weeks in 8 perinatal centers that participated in the APOSTEL-II trial. We studied only the first admission with threatened preterm labor, readmissions were excluded. We distinguished between the period before, the period during and the period after the trial. In a subgroup analysis, we differentiated for the group of women who delivered and for the group of women who did not deliver during the initial admission.
  
  
  RESULTS
  The mean length of hospital admission was 9.3 days before the start of the trial, 8.4 days during the recruitment period and 8.1 days after the trial was completed. The difference in mean length of hospital admission before and during the recruitment period was significantly different (p<001).
  
  
  CONCLUSIONS
  The length of hospital admission of women with threatened preterm labor is found to be reduced during the recruitment period of the APOSTEL-II trial. This shows that the conduct of a randomized controlled trial itself has the potential to change daily practice.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: delangets@gmail.com.
authors.forename: Thomas S de
authors.initials: TS
authors.lastname: Lange
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: Carolien.Roos@radboudumc.nl.
authors.forename: Carolien
authors.initials: C
authors.lastname: Roos
authors.affiliation: Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: k.w.m.bloemenkamp@lumc.nl.
authors.forename: Kitty W M
authors.initials: KW
authors.lastname: Bloemenkamp
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: Annemieke.Bolte@radboudumc.nl.
authors.forename: Antoinette C
authors.initials: AC
authors.lastname: Bolte
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: j.j.duvekot@erasmusmc.nl.
authors.forename: Johannes J J
authors.initials: JJ
authors.lastname: Duvekot
authors.affiliation: Department of Obstetrics and Gynecology, University of Groningen, Academic Medical Center, Groningen, The Netherlands. Electronic address: m.t.m.franssen@og.umcg.nl.
authors.forename: Maureen T M
authors.initials: MT
authors.lastname: Franssen
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: m.kok@amc.uva.nl.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Kok
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center, Utrecht, The Netherlands. Electronic address: m.a.oudijk-3@umcutrecht.nl.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Oudijk
authors.affiliation: Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: m.porath@mmc.nl.
authors.forename: Martina M
authors.initials: MM
authors.lastname: Porath
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: j.a.vanderpost@amc.uva.nl.
authors.forename: Joris A M
authors.initials: JA
authors.lastname: van der Post
authors.affiliation: School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide 5000, SA, Australia. Electronic address: ben.mol@adelaide.edu.au.
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D005260:Female; D005865:Gestational Age; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D009426:Netherlands; D009543:Nifedipine / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D012189:Retrospective Studies; D015149:Tocolytic Agents / Q000627:therapeutic use*
chemical_list: D015149:Tocolytic Agents; D009543:Nifedipine
keywords: Admission; Maintenance tocolysis; Threatened preterm labor