Evaluation of the efficacy of atosiban in pregnant women with threatened preterm labor associated with assisted reproductive technology

Y.-J. Xu, L.-M. Ran, S.-S. Zhai, X.-H. Luo, Y.-Y. Zhang, Z.-Y. Zhou, Y.-H. Liu, L.-D. Ren, T. Hong, R. Liu

Department of Obstetrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China. cnzzzsl@163.com

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• Pharmacology

OBJECTIVE: The present study aimed to investigate the effectiveness of atosiban in treating women with threatened preterm labor who had become pregnant through assisted reproductive technology (ART) and the corresponding pregnancy outcomes.

PATIENTS AND METHODS: Seventy pregnant women with threatened preterm labor after ART were randomly divided into two groups, with 35 cases in the atosiban group and 35 in the ritodrine group. The post-treatment effects and the corresponding pregnancy outcomes were observed.

RESULTS: The efficacy of extending gestational age by 48 hours was significantly higher in the atosiban group than in the ritodrine group (p<0.05), whereas the efficacy of extending gestational  age by seven days was the same in the two groups (p>0.05). There was no significant difference between the atosiban and ritodrine groups in the average gestational age at birth (p<0.05). The occurrence of side effects in the pregnant women was higher in the ritodrine group than in the atosiban group (p<0.05), although the prevalence of abnormal fetal heart rate was not significantly different (p>0.05). Both the perinatal mortality rate and the prevalence of neonatal asphyxia were significantly lower in the atosiban group than in the ritodrine group (p<0.05). When the medication was applied at a gestational age of fewer than 28 weeks, the perinatal mortality rate and the prevalence of neonatal pneumonia were significantly lower in the atosiban group compared with the ritodrine group (p<0.05). When the first drug administration was at a gestational age of 28 weeks or later, the need for neonatal pediatric treatment was significantly reduced in the atosiban group relative to the ritodrine group. Independent of when the drug administration was initiated, there were no significant differences between the atosiban and ritodrine groups in the occurrences of neonatal asphyxia, acute respiratory distress syndrome (ARDS), neonatal brain injury, or neonatal sepsis (p>0.05).

CONCLUSIONS: Administration of atosiban has a comparatively better effect than that of ritodrine on pregnant women who underwent ART and is safe and effective at preventing immediate preterm birth. Atosiban is significantly better than ritodrine at reducing the rates of perinatal mortality and neonatal pneumonia, and the perinatal outcomes for those who began to use atosiban at a gestational age of fewer than 28 weeks were even better.

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