Impact of combined propranolol and oxytocin on the process and outcomes of labor: a meta-analysis of randomized controlled trials.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2024-06-01 Epub Date: 2024-03-04 DOI:10.1007/s00228-024-03659-9

Xia Liu, Hai-Xu Chen, Bo Chen

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引用次数: 0

Abstract

Purpose: To systematically review the impact of propranolol combined with oxytocin on the process and outcomes of labor.

Methods: A comprehensive literature search was performed across multiple databases, including China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biomedical Literature Database, PubMed, Embase, and the Cochrane Library. All publicly published randomized controlled trials (RCTs) of propranolol combined with oxytocin compared to the use of oxytocin alone in labor were collected. After screening the literature and extracting data, the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 recommended bias risk assessment tool was used to assess the quality of the included studies. A meta-analysis was conducted using RevMan 5.3 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the quality of evidence for outcome measures.

Results: Meta-analysis results showed that the group receiving propranolol combined with oxytocin was more capable of reducing the cesarean section rate (eight studies, 815 women, RR = 0.67, 95% CI (0.53, 0.86), P = 0.001) and shortening the duration of the latent phase (two studies, 206 women, MD = - 1.20, 95% CI (- 1.97, - 0.43), P = 0.002) and the duration of the active phase on day 1 (two studies, 296 women, MD = - 0.69, 95% CI (- 0.83, - 0.54), P < 0.00001), compared to the oxytocin monotherapy group. No significant difference was found between the two groups in terms of the 5-min Apgar score (five studies, 609 women, MD = - 0.05, 95% CI (- 0.14, 0.04), P = 0.32) and the rate of admissions to the Neonatal Intensive Care Unit (NICU) (three studies, 359 women, RR = 0.82, 95% CI (0.38, 1.79), P = 0.62).

Conclusion: The combined use of propranolol and oxytocin can significantly reduce the cesarean section rate, shorten the duration of the latent phase and the duration of the active phase on day 1, and is safe. However, due to the limitations, the conclusions of this article still need to be verified by large-sample, multicenter, rigorously designed high-quality clinical RCTs.

Trial registration: Registration number is INPLASY202390107.

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联合使用普萘洛尔和催产素对分娩过程和结果的影响：随机对照试验荟萃分析。

目的：系统回顾普萘洛尔联合催产素对分娩过程和结果的影响：在中国知网（CNKI）、VIP、万方、中国生物医学文献数据库、PubMed、Embase 和 Cochrane 图书馆等多个数据库中进行了全面的文献检索。收集了所有公开发表的普萘洛尔联合催产素与单独使用催产素的随机对照试验（RCT）。在筛选文献和提取数据后，使用《科克伦干预措施系统综述手册》5.1.0 推荐的偏倚风险评估工具来评估纳入研究的质量。使用RevMan 5.3软件进行了荟萃分析，并使用建议评估、发展和评价分级（GRADE）系统对结果测量的证据质量进行了评级：Meta 分析结果显示，接受普萘洛尔联合催产素治疗组更能降低剖宫产率（8 项研究，815 名产妇，RR = 0.67，95% CI (0.53，0.86)，P = 0.联合使用普萘洛尔和催产素可显著降低剖宫产率，缩短潜伏期和第 1 天活跃期的持续时间，并且是安全的。但由于条件限制，本文的结论仍需大样本、多中心、严谨设计的高质量临床 RCT 验证：注册号为 INPLASY202390107。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.