BACKGROUND: Magnesium maintenance therapy is one of the types of tocolytic therapy used after an episode of threatened preterm labour (and usually an initial dose of tocolytic therapy) in an attempt to prevent the onset of further preterm contractions. OBJECTIVES: To assess the effects of magnesium maintenance therapy on preventing preterm birth after threatened preterm labour. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (August 2002). SELECTION CRITERIA: Randomised controlled trials of magnesium therapy given to women after threatened preterm labour. DATA COLLECTION AND ANALYSIS: Trial quality assessment and data extraction were done independently by two reviewers. MAIN RESULTS: Three trials, which recruited 303 women, were included. Two trials were of poor quality and none included any long-term follow up of infants. No differences in the incidence of preterm birth or perinatal mortality were seen when magnesium maintenance therapy was compared with placebo or no treatment; or alternative therapies (ritodrine or terbutaline). The relative risk (RR) for preterm birth (less than 37 weeks) for magnesium compared with placebo or no treatment was 0.85, 95% confidence interval (CI) 0.47 to 1.51; and 0.98, 95% CI 0.56 to 1.72 for magnesium compared with alternative therapies. The RR for perinatal mortality for magnesium compared with placebo or no treatment, and also compared with alternative treatments, was 5.00, 95% CI 0.25 to 99.16. Women taking magnesium preparations were less likely to report palpitations or tachycardia than women receiving alternative therapies (RR 0.22, 95% CI 0.11 to 0.44) but were much more likely to experience diarrhoea (RR 10.67, 95% CI 3.35 to 33.99). AUTHORS' CONCLUSIONS: There is not enough evidence to show any difference between magnesium maintenance therapy and either placebo or no treatment, or alternative therapies (ritodrine or terbutaline) in preventing preterm birth after an episode of threatened preterm labour. MAGNESIUM MAINTENANCE THERAPY FOR PREVENTING PRETERM BIRTH AFTER THREATENED PRETERM LABOUR: Magnesium, given to women after threatening to give birth too early, does not reduce preterm birth or improve the outcome for the infant.Babies born prematurely may not survive, or may have later problems if they do survive. After other drugs have been used to try to stop early labour, magnesium is used to prevent further early contractions. This review did not show that magnesium used in this way helped prevent preterm birth, but this finding is based on very few studies, and none of them looked at the infants' later development.
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