Prepared by:
Research Triangle Institute, Research Triangle Park, NC
Nancy D. Berkman, Ph.D.
Principal Investigator
John M. Thorp, Jr., M.D.
Katherine E. Hartmann, M.D., Ph.D.
Kathleen N. Lohr, Ph.D.
Anjolie E. Idicula, B.A.
Melissa McPheeters, M.P.H.
Norma I. Gavin, Ph.D.
Timothy S. Carey, M.D.
Sue Tolleson-Rinehart, Ph.D.
Anne M. Jackman, M.S.W.
Victor Hasselblad, Ph.D.
Emily C. Puckett, B.A.
Investigators
File Name Description Software Version File Size __________________________________________________________________________________________________________ 01front.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 32KB 8 pages Contents: Cover Page, Title Page (Volume 1), Preface, Structured Abstract __________________________________________________________________________________________________________ 02cont.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 45KB 4 pages Contents: Table of Contents (Volume 1) __________________________________________________________________________________________________________ 03summ.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 39KB 10 pages Contents: Contents: Summary __________________________________________________________________________________________________________ 04chap1.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 85KB 20 pages Contents: Contents: Chapter 1. Introduction: Primary Objectives and Scope, Table 1. Existing Information on Preterm Labor, Key Clinical Questions, Technical Expert Advisory Group, Background and Significance, Clinical Management of Preterm Labor, Organization of this Report __________________________________________________________________________________________________________ 05chap2.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 147KB 40 pages Contents: Chapter 2. Methodology: Key Questions and Causal Pathways; Literature Search; Table 2. Management of preterm labor: inclusion/exclusion criteria; Literature Retrieval Process; Figure 5. Article eligibility screen; Table 3. Search results by topic; Data Abstraction Process; Table 4. Biologic markers search strategy; Table 6. Harms related to tocolytic use search strategy; Table 7. Antibiotic search strategy; Table 8. Home uterine activity monitoring search strategy; Table 9. Costs and cost analyses search strategy; Table 10. Categories of maternal and fetal/newborn harms related to tocolytic treatment; Quality Control, Adjudication, and Reliability; Quality Rating Development and Analysis; Development of the Evidence Tables; Peer Review Process; Table 11. Content of study design and outcomes evidence tables; Supplemental Analysis __________________________________________________________________________________________________________ 06fig1-4.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 111KB 4 pages Contents: Figure 1. Causal pathway: Biologic markers, Figure 2. Causal pathway: Tocolytics, Figure 3. Causal pathway: Antibiotics, Figure 4. Causal pathway: Home uterine activity monitoring (Chapter 2) __________________________________________________________________________________________________________ 07tab5.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 9KB 1 page Contents: Table 5. Tocolytic search strategy (Chapter 2) __________________________________________________________________________________________________________ 08fig6.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 15KB 3 pages Contents: Figure 6. Quality of articles form: Categories and points for grading literature Preterm labor: Antibiotics and tocolytics literature (Chapter 2) __________________________________________________________________________________________________________ 09fig7.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 15KB 2 pages Contents: Figure 7. Quality of articles form: Categories and points for grading biologic marker literature (Chapter 2) __________________________________________________________________________________________________________ 10fig8.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 12KB 2 pages Contents: Figure 8. Quality of articles form: Categories and points for grading literature HUAM (Chapter 2) __________________________________________________________________________________________________________ 11chap3.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 129KB 38 pages Contents: Chapter 3. Results: Introduction, Issues and Limitations in the Literature, Biologic Markers, Tocolytics, Antibiotics, Home Uterine Activity Monitoring __________________________________________________________________________________________________________ 12fig9.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 130KB 1 page Contents: Figure 9. Use of fFN to adjust clinical estimates of risk for preterm birth (Chapter 3) __________________________________________________________________________________________________________ 13fig10.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 122KB 1 page Contents: Figure 10. Use of EVUSD to adjust clinical estimates of risk for preterm birth (Chapter 3) __________________________________________________________________________________________________________ 14tab12.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 14KB 1 page Contents: Table 12. Predictive value of biologic markers in women with symptoms of preterm labor (Chapter 3) __________________________________________________________________________________________________________ 15f11-20.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 1.3MB 10 pages Contents: Figure 11. Maternal harms - serious cardiovascular, Figure 12. Maternal harms - minor cardiovascular, Figure 13. Maternal harms - metabolic, Figure 14. Maternal harms - gastrointestinal, Figure 15. Maternal harms - psychologic, Figure 16. Fetal/newborn harms - ductal constriction/tricuspid regurgitation, Figure 17. Fetal/newborn harms - IVH, Figure 18. Fetal/newborn harms - NEC, Figure 19. Fetal/newborn harms - sepsis, Figure 20. Fetal harms - tachycardia (Chapter 3) __________________________________________________________________________________________________________ 16chap4.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 532KB 20 pages Contents: Chapter 4. Meta-Analyses: Introduction; Methods; Results; Table 13. Trial arms used in the meta-analysis of first-line tocolytics: Odds ratio for delivery at term (at or beyond 36 to 38 weeks gestation); Table 14. Effect of first-line tocolytics: Odds of delivery at term (at or beyond 36 to 38 weeks gestation); Figure 21. Meta-analysis results: Effect of first-line tocolytics on the odds of delivery at term (at or beyond 36 to 38 weeks gestation), by tocolytic class; Table 15. Studies of the effects of tocolytics as maintenance therapies; Table 16. Effect of maintenance tocolytics on pregnancy outcomes; Figure 22. Meta-analysis results: Effect of maintenance beta-mimetics on mean gestational age relative to placebo; Figure 23. Meta-analysis results: Effect of maintenance magnesium sulfate on mean gestational age relative to placebo; Figure 24. Meta-analysis: Effect of maintenance beta-mimetics on prolongation of pregnancy relative to placebo; Figure 25. Meta-analysis results: Effect of maintenance magnesium sulfate on prolongation of pregnancy relative to placebo; Figure 26. Meta-analysis results: Effect of maintenance beta-mimetics on birth weight relative to placebo; Table 17. Homogeneity of effects of maintenance tocolytics on pregnancy outcomes; Table 18. Effect of antibiotics on prolongation of pregnancy (measured in days); Table 19. Effect of antibiotics on estimated gestational age at birth (measured in weeks); Table 20. Effect of antibiotics on birth weight (measured in kilograms); Figure 27. Meta-analysis results: Effect of maintenance magnesium sulfate on birth weight relative to placebo; Figure 28. Meta-analysis: Effect of adjunctive antibiotics on prolongation of pregnancy relative to no antibiotics; Figure 29. Meta-analysis results: Effect of adjunctive antibiotics on estimated gestation age at birth relative to no antibiotics; Figure 30. Meta-analysis results: Effect of adjunctive antibiotics on birth weight relative to no antibiotics; Table 21. Effect of home uterine activity monitoring on pregnancy outcomes; Figure 31. Meta-analysis results: Effect of home uterine activity monitoring on the odds on the odds of delivery at 37 or more weeks gestation relative to no monitoring; Figure 32. Meta-analysis results: Effect of home uterine activity monitoring on gestational age relative to no monitoring; Figure 33. Meta-analysis results: Effect of home uterine activity monitoring on birth weight relative to monitoring; Table 22. Homogeneity of effects of home uterine activity monitoring on pregnancy outcomes; Summary and Conclusions __________________________________________________________________________________________________________ 17chap5.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 32KB 6 pages Contents: Chapter 5. Conclusions: Introduction, Grading the Evidence, Biologic Markers, Tocolytics, Antibiotics, Home Uterine Activity Monitoring __________________________________________________________________________________________________________ 18chap6.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 27KB 6 pages Contents: Chapter 6. Recommendations for Future Research: Definitional and Methods Issues, A Future Research Agenda __________________________________________________________________________________________________________ 19refs.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 95KB 11 pages Contents: References __________________________________________________________________________________________________________ 20biblio.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 197KB 32 pages Contents: Bibliography __________________________________________________________________________________________________________ 21appa.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 16KB 5 pages Contents: Appendix A. Acknowledgments __________________________________________________________________________________________________________ 22appb.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 191KB 34 pages Contents: Appendix B. Extraction Forms __________________________________________________________________________________________________________ 23appc.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 37KB 2 pages Contents: Appendix C. Acronyms and Abbreviations
__________________________________________________________________________________________________________ 24title2.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 5KB 1 page Contents: Title Page for Volume 2, Evidence Tables __________________________________________________________________________________________________________ 25etab1.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 94KB 24 pages Contents: Evidence Table 1: Biologic markers: Fetal fibronectin __________________________________________________________________________________________________________ 26etab2.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 42KB 8 pages Contents: Evidence Table 2: Biologic markers: Endovaginal ultrasound __________________________________________________________________________________________________________ 27etab3.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 738KB 176 pages Contents: Evidence Table 3: Tocolytic first line: Beta-mimetics __________________________________________________________________________________________________________ 28etab4.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 252KB 57 pages Contents: Evidence Table 4: Tocolytic first line: Calcium channel blockers __________________________________________________________________________________________________________ 29etab5.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 352KB 80 pages Contents: Evidence Table 5: Tocolytic first line: Magnesium sulfate __________________________________________________________________________________________________________ 30etab6.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 158KB 36 pages Contents: Evidence Table 6: Tocolytic first line: Nonsteroidal Anti-inflammatory agents __________________________________________________________________________________________________________ 31etab7.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 113KB 24 pages Contents: Evidence Table 7: Tocolytic first line: Other __________________________________________________________________________________________________________ 32etab8.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 223KB 52 pages Contents: Evidence Table 8: Tocolytic maintenance: Beta-mimetics __________________________________________________________________________________________________________ 33etab9.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 19KB 4 pages Contents: Evidence Table 9: Tocolytic maintenance: Calcium channel blockers __________________________________________________________________________________________________________ 34etab10.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 56KB 12 pages Contents: Evidence Table 10: Tocolytic maintenance: Magnesium sulfate __________________________________________________________________________________________________________ 35etab11.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 20KB 4 pages Contents: Evidence Table 11: Tocolytic maintenance: Nonsteroidal anti-inflammatory agents __________________________________________________________________________________________________________ 36etab12.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 241KB 48 pages Contents: Evidence Table 12: Antibiotics __________________________________________________________________________________________________________ 37etab13.wpd WordPerfect® Document Corel WordPerfect® 6/7/8 37KB 8 pages Contents: Evidence Table 13: Home Uterine Activity Monitoring __________________________________________________________________________________________________________
AHRQ Publication No. 01-E021
Current as of December 2000
Internet Citation:
Management of Preterm Labor. File Inventory, Evidence Report/Technology Assessment Number 18. AHRQ Publication No. 01-E021, December 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/prtrminv.htm
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