Tichelaar, M.A. (Marijn) (2018) No clear Difference in Tocolysis with Nifedipine or Atosiban on 2, 5 - 5,5 Year Infant development : A Follow-up of the Apostel III trial. thesis, Medicine.
Full text available on request.Abstract
BACKGROUND: Worldwide, in 50-75% of perinatal mortality, preterm birth is a risk factor. Tocolytic drugs are given to women with threatened preterm birth, to delay this and to give other medication time to improve fetal outcome. The Apostel III trial was a multicenter RCT that compared safety and effectiveness of tocolytic drugs nifedipine and atosiban in women with threatened preterm birth. No significant difference was found in the primary outcome, a composite of short-term neonatal morbidity and mortality. In this follow-up study, the longterm effects of nifedipine and atosiban on the offspring of women in the Apostel III was researched. METHODS: The 505 women previously randomized in the Apostel III trial were asked to complete questionnaires on health and development of their child(ren), now aged 2.5-5.5. These standardized questionnaires were processed using cut-off points of scale scores in specific fields of child development to determine the number of divergent (poor) outcome per study group. A subgroup analysis was performed to compare full term born children with children in norm groups from the questionnaires user manuals. RESULTS: 194 women returned the questionnaires (response rate 52%). In the nifedipine group (n=114), the number of divergent scores was significantly higher in CBCL scale DSM Oppositional Defiant Problems, compared to the atosiban group (n=108). In the subgroup analysis, no clinically significant difference was found between the subjects born full term and the subjects from the questionnaires norm groups. CONCLUSION: In this long-term follow-up study of the Apostel III, a significant difference was found in one developmental scale. Still, no definite recommendation can be made in the choice for either nifedipine or atosiban as tocolytic agent.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Gordijn, dr. S.J. |
| Supervisor name: | Second supervisor: dr. M.A. Oudijk and Daily supervisor: drs. T.M.S. van Winden and Location: Amsterdam UMC, location AMC |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/581 |
Actions (login required)
 |
View Item |