- 1. Department pharmacy, Third Hospital Peking University, Bejing 100083, China2. Department pharmacy, First Hospital Lanzhou University, Lanzhou 730000, China3. Department of obstetrics, First Hospital Lanzhou University, Lanzhou 730000, China4. Department of surgery, First Hospital Lanzhou University, Lanzhou 730000, China;
Objective To assess the effectiveness and safety of salbutamol in the treatment of preterm labor.
Methods We searched MEDLINE (1966-Jan. 2007), EMBASE (1966-Jan. 2007), Cochrane Central Register of Controlled Trials (Issue 4, 2006), CBMdisc (1978-Jan. 2007) and CNKI (1979-Jan. 2007). Randomized controlled trials (RCTs) or quasi-randomized controlled trials (quasi-RCT) involving salbutamol for preterm labor were collected. The quality of the retrieved trials was assessed using the Jadad Scale. Meta-analyses were conducted with The Cochrane Collaboration’s RevMan 4.2 software.
Results A total of 19 RCTs and quasi-RCTs were included, of which 16 were published in Chinese and 3 in English. The quality of the 16 Chinese studies was low, scored less than 3 by the Jadad Scale. None of the 16 RCTs mentioned the method of randomization, allocation concealment, double-blinding or the long-term effect. The quality of the 3 English studies was high. Compared with basic treatment, salbutamol was more effective in prolonging pregnancy over 48 hours (RR=6.30, 95%CI 3.23 to 14.32), and preventing neonatal asphyxia (RR=0.44, 95%CI 0.33 to 0.59), but the incidence of adverse events in pregnant women was higher in the salbutamol group (RR=4.57, 95%CI 1.34 to 15.54). Salbutamol was as effective as magnesium sulfate in prolonging pregnancy over 48 hours (OR=1.60, 95%CI 0.92 to 2.76), but more effective in preventing neonatal asphyxia (OR=0.29, 95%CI 0.14 to 0.61). Salbutamol was similar to atosiban in terms of prolonging pregnancy over 48 hours (OR=1.18, 95%CI 0.42 to 3.37) and preventing neonatal asphyxia (OR=1.13, 95%CI 0.30 to 4.31).
Conclusion Salbutamol is effective in prolonging pregnancy over 48 hours and preventing neonatal asphyxia, but may cause more adverse events in pregnant women. Salbutamol has similar effects to other commonly-used drugs in regard to prolonging pregnancy over 48 hours, but is better than magnesium sulfate in decreasing the incidence of neonatal asphyxia. Salbutamol may lead to more adverse events compared with atosiban, but fewer adverse events than magnesium sulfate.
Citation： MIN Guangning,LIU Fang,ZHAI Shuodi,ZHU Jinsong,ZHANG Hong,WANG Ting. Salbutamol in Preventing Preterm Labour: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2007, 07(8): 591-600. doi: Copy
| 1. | Jiang XH. Clinical observation of alternative use of magnesium sulfate and sulfuric acid to cure the prematurity. Journal of Huaihai Medicine, 2004, 22(6): 452-453. |
| 2. | Chen SX, Yang PH, Lv SY. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Chinese Journal of Clinical Obstetric and Gynecology, 2005, 6(6): 456-457. |
| 3. | Xia ML. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Contemporary Medicine , 2006, (10): 88-89. |
| 4. | Chen DL. Clinical observation of albuterol sulfate treatment premature labor of 35 cases. Journal of Guiyang Medical College, 1996, 21(2): 144-145. |
| 5. | Li DM, Zhou XD. Observations on treatment of premature labor with salbutamol sulphate - an analysis of 45 cases. Journal of Shanxi Medical College for Continuing Educatlon, 1997, 7(2): 11-13. |
| 6. | Ying XY. Salbutamol treatment premature labor. Academic Journal of Kaifeng Medical College, 1998, 17(1): 11-13. |
| 7. | Teng JF. Effect analysis of albuterol sulfate treatment premature labor. Qingdao Medical Journal , 1998, 30(12): 42. |
| 8. | Xiao QG. Clinical observation of albuterol sulfate treatment premature labor of 66 cases. Maternal and Child Health Care of China, 2003, 18(6): 374. |
| 9. | Wang JF. Clinical observation of albuterol sulfate treatment premature labor of 74 cases. Central Plains Medical Journal, 2004, 31(15): 49-50. |
| 10. | Gao XF. Clinical observation of albuterol sulfate treatment premature labor of 54 cases. Proceeding of Clinical Medicine, 2006, 15(8): 629-630. |
| 11. | Xing LY. Clinical observation of albuterol sulfate treatment premature labor of 48 cases. Shanxi Medical Journal, 1999, 28(6): 373. |
| 12. | Li Y, Ma YH. Application of salbutamol treatment threatened premature labor. Henan Medical Information, 2001, 9(8): 64. |
| 13. | Yu DF. Study of magnesium sulfate, salbutamol treatment premature labor of 48 cases. Acta Academidae Medicinae Suzhou, 1995, 15(2): 346. |
| 14. | Jin YJ. Clinical observation of albuterol sulfate treatment premature labor of 108 cases. Modern Medicine & Health, 2006, 22(11): 1693-1694. |
| 15. | Liu WQ, Yu LX, Zhu P. Clinical observation of nifedipine treatment premature labor.Qingdao Medical Journal, 1996, 28(9): 12-13. |
| 16. | Zhao RX, Liu YY, Li LJ. Efficacy of nifedipine in management of premature labor. Clinical Misdiagnosis & Mistherapy, 2006, 19(3): 6-7. |
| 17. | Xiang J. Clinical observation of nifedipine treatment premature labor . Medical Journal of Communications, 2003, 17(6) : 704-705. |
| 18. | Wang ZX. Report of albuterol sulfate treatment premature labor of 54 cases. Chinese Journal of Rural Medicine and Pharmacy, 1997, 4(7): 17. |
| 19. | Liu DY. Treatment premature labor—An analysis of 146 cases. Anthology of Medicine, 2005, 24 (4): 548-549. |
| 20. | Chen JZ, Cao ZX, Wu WX. Inhibitor of uterine contraction treatment threatened premature labor of 146 cases. Chongqing Medical Journal, 1990, 19(3): 19-20. |
| 21. | Am J Obstet Gynecol, 2004, 191(3): 683-690. |
| 22. | Guyer B, Strobino DM, Ventura SJ, et al. Annual summary in vital statistics: 1995. Pediatrics 1996; 98: 1007-1019. Bibliographic Links Library Holdings. |
| 23. | Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996 , 17(1): 1-12. |
| 24. | 江雪华. 硫酸镁、硫酸舒喘灵交替使用治疗早产临床观察. 淮海医药, 2004, 22(6): 452~453. |
| 25. | 陈淑霞, 杨培红, 吕素英. 硫酸镁联合硫酸舒喘灵治疗先兆早产临床观察. 中国妇产科临床杂志, 2005, 6(6): 456~457. |
| 26. | 夏丽美. 硫酸镁联合硫酸舒喘灵治疗先兆早产临床观察. 当代医学, 2006, (10): 88~89. |
| 27. | 陈达丽. 硫酸舒喘灵治疗早产35例疗效观察. 贵阳医学院学报, 1996, 21(2): 144~145. |
| 28. | 李冬梅, 周衔弟. 硫酸舒喘灵治疗早产45例临床观察. 山西职工医学院学报, 1997, 7(2): 11~13. |
| 29. | 尹学英. 硫酸舒喘灵在早产治疗中的应用. 河南大学学报(医学科学版), 1998, 17(1): 11~13. |
| 30. | 滕金凤. 硫酸舒喘灵治疗早产效果分析. 青岛医药卫生, 1998, 30(12): 42. |
| 31. | 肖秋桂. 硫酸舒喘灵治疗早产66例疗效观察. 中国妇幼保健, 2003, 18(6): 374. |
| 32. | 王进凤. 硫酸舒喘灵治疗早产74例临床报告. 中原医刊, 2004, 31(15): 49~50. |
| 33. | 高晓芳. 硫酸舒喘灵治疗早产54例疗效观察. 临床医药实践杂志, 2006, 15(8): 629~630. |
| 34. | 邢兰瑛. 硫酸舒喘灵治疗早产48例疗效观察. 陕西医学杂志, 1999, 28(6): 373. |
| 35. | 李岩, 马玉红. 硫酸舒喘灵在先兆早产中的应用. 河南医药信息, 2001, 9(8): 64. |
| 36. | 于德凤. 硫酸镁、舒喘灵治疗早产142例报告. 苏州医学院学报, 1995, 15(2): 346. |
| 37. | 金玉杰. 硫酸舒喘灵治疗108例早产的临床观察. 现代医药卫生, 2006, 22(11): 1693~1694. |
| 38. | 刘维琴, 于丽霞, 朱萍. 硝苯吡啶治疗早产的效果观察. 青岛医药卫生, 1996, 28(9): 12~13. |
| 39. | 赵荣衔, 刘元昀, 李丽君. 硝苯地平治疗早产的疗效观察. 临床误诊误治, 2006, 19(3): 6~7. |
| 40. | 向京. 硝苯吡啶治疗早产的临床观察. 交通医学, 2003, 17(6): 704~705. |
| 41. | 王泽香. 硫酸舒喘灵治疗早产54例报告. 中国乡村医药, 1997, 4(7): 17. |
| 42. | 刘冬艳. 146例早产妇治疗分析. 医学文选, 2005, 24(4): 548~549. |
| 43. | 梁淑花. 硫酸舒喘灵治疗45例先兆早产疗效观察. 航空航天医药, 2004, (1): 37.Liang SH. Effect of albuterol sulfate treatment premature labor of 45 Cases. Aerospace Medicine, 2004, (1): 37. |
| 44. | 陈建宗, 曹珍修, 吴味辛. 先兆早产宫缩抑制剂治疗63例分析. 重庆医药, 1990, 19(3): 19~20. |
| 45. | Jannet D, Abankwa A, Guyard B, et al. Nicardipine versus salbutamol in the treatment of premature labor. A prospective randomized study. Eur J Obstet Gynecol Reprod Biol, 1997, 73(1): 11-16. |
| 46. | French/Australian Atosiban Investigators Group. Treatment of preterm labor with the oxytocin antagonist atosiban: a double-blind, randomized, controlled comparison with salbutamol. Eur J Obstet Gynecol Reprod Biol, 2001, 98(2): 177-185. |
| 47. | Bisits A, Madsen G, Knox M, et al. The Randomized Nitric Oxide Tocolysis Trial (RNOTT) for the treatment of preterm labor. |
| 48. | Anotayanonth S, Subhedar NV, Garner P, et al. Betamimetics for inhibiting preterm labour. Cochrane Database Syst Rev, 2004, (4): CD004352. |
- 1. Jiang XH. Clinical observation of alternative use of magnesium sulfate and sulfuric acid to cure the prematurity. Journal of Huaihai Medicine, 2004, 22(6): 452-453.
- 2. Chen SX, Yang PH, Lv SY. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Chinese Journal of Clinical Obstetric and Gynecology, 2005, 6(6): 456-457.
- 3. Xia ML. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Contemporary Medicine , 2006, (10): 88-89.
- 4. Chen DL. Clinical observation of albuterol sulfate treatment premature labor of 35 cases. Journal of Guiyang Medical College, 1996, 21(2): 144-145.
- 5. Li DM, Zhou XD. Observations on treatment of premature labor with salbutamol sulphate - an analysis of 45 cases. Journal of Shanxi Medical College for Continuing Educatlon, 1997, 7(2): 11-13.
- 6. Ying XY. Salbutamol treatment premature labor. Academic Journal of Kaifeng Medical College, 1998, 17(1): 11-13.
- 7. Teng JF. Effect analysis of albuterol sulfate treatment premature labor. Qingdao Medical Journal , 1998, 30(12): 42.
- 8. Xiao QG. Clinical observation of albuterol sulfate treatment premature labor of 66 cases. Maternal and Child Health Care of China, 2003, 18(6): 374.
- 9. Wang JF. Clinical observation of albuterol sulfate treatment premature labor of 74 cases. Central Plains Medical Journal, 2004, 31(15): 49-50.
- 10. Gao XF. Clinical observation of albuterol sulfate treatment premature labor of 54 cases. Proceeding of Clinical Medicine, 2006, 15(8): 629-630.
- 11. Xing LY. Clinical observation of albuterol sulfate treatment premature labor of 48 cases. Shanxi Medical Journal, 1999, 28(6): 373.
- 12. Li Y, Ma YH. Application of salbutamol treatment threatened premature labor. Henan Medical Information, 2001, 9(8): 64.
- 13. Yu DF. Study of magnesium sulfate, salbutamol treatment premature labor of 48 cases. Acta Academidae Medicinae Suzhou, 1995, 15(2): 346.
- 14. Jin YJ. Clinical observation of albuterol sulfate treatment premature labor of 108 cases. Modern Medicine & Health, 2006, 22(11): 1693-1694.
- 15. Liu WQ, Yu LX, Zhu P. Clinical observation of nifedipine treatment premature labor.Qingdao Medical Journal, 1996, 28(9): 12-13.
- 16. Zhao RX, Liu YY, Li LJ. Efficacy of nifedipine in management of premature labor. Clinical Misdiagnosis & Mistherapy, 2006, 19(3): 6-7.
- 17. Xiang J. Clinical observation of nifedipine treatment premature labor . Medical Journal of Communications, 2003, 17(6) : 704-705.
- 18. Wang ZX. Report of albuterol sulfate treatment premature labor of 54 cases. Chinese Journal of Rural Medicine and Pharmacy, 1997, 4(7): 17.
- 19. Liu DY. Treatment premature labor—An analysis of 146 cases. Anthology of Medicine, 2005, 24 (4): 548-549.
- 20. Chen JZ, Cao ZX, Wu WX. Inhibitor of uterine contraction treatment threatened premature labor of 146 cases. Chongqing Medical Journal, 1990, 19(3): 19-20.
- 21. Am J Obstet Gynecol, 2004, 191(3): 683-690.
- 22. Guyer B, Strobino DM, Ventura SJ, et al. Annual summary in vital statistics: 1995. Pediatrics 1996; 98: 1007-1019. Bibliographic Links Library Holdings.
- 23. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996 , 17(1): 1-12.
- 24. 江雪华. 硫酸镁、硫酸舒喘灵交替使用治疗早产临床观察. 淮海医药, 2004, 22(6): 452~453.
- 25. 陈淑霞, 杨培红, 吕素英. 硫酸镁联合硫酸舒喘灵治疗先兆早产临床观察. 中国妇产科临床杂志, 2005, 6(6): 456~457.
- 26. 夏丽美. 硫酸镁联合硫酸舒喘灵治疗先兆早产临床观察. 当代医学, 2006, (10): 88~89.
- 27. 陈达丽. 硫酸舒喘灵治疗早产35例疗效观察. 贵阳医学院学报, 1996, 21(2): 144~145.
- 28. 李冬梅, 周衔弟. 硫酸舒喘灵治疗早产45例临床观察. 山西职工医学院学报, 1997, 7(2): 11~13.
- 29. 尹学英. 硫酸舒喘灵在早产治疗中的应用. 河南大学学报(医学科学版), 1998, 17(1): 11~13.
- 30. 滕金凤. 硫酸舒喘灵治疗早产效果分析. 青岛医药卫生, 1998, 30(12): 42.
- 31. 肖秋桂. 硫酸舒喘灵治疗早产66例疗效观察. 中国妇幼保健, 2003, 18(6): 374.
- 32. 王进凤. 硫酸舒喘灵治疗早产74例临床报告. 中原医刊, 2004, 31(15): 49~50.
- 33. 高晓芳. 硫酸舒喘灵治疗早产54例疗效观察. 临床医药实践杂志, 2006, 15(8): 629~630.
- 34. 邢兰瑛. 硫酸舒喘灵治疗早产48例疗效观察. 陕西医学杂志, 1999, 28(6): 373.
- 35. 李岩, 马玉红. 硫酸舒喘灵在先兆早产中的应用. 河南医药信息, 2001, 9(8): 64.
- 36. 于德凤. 硫酸镁、舒喘灵治疗早产142例报告. 苏州医学院学报, 1995, 15(2): 346.
- 37. 金玉杰. 硫酸舒喘灵治疗108例早产的临床观察. 现代医药卫生, 2006, 22(11): 1693~1694.
- 38. 刘维琴, 于丽霞, 朱萍. 硝苯吡啶治疗早产的效果观察. 青岛医药卫生, 1996, 28(9): 12~13.
- 39. 赵荣衔, 刘元昀, 李丽君. 硝苯地平治疗早产的疗效观察. 临床误诊误治, 2006, 19(3): 6~7.
- 40. 向京. 硝苯吡啶治疗早产的临床观察. 交通医学, 2003, 17(6): 704~705.
- 41. 王泽香. 硫酸舒喘灵治疗早产54例报告. 中国乡村医药, 1997, 4(7): 17.
- 42. 刘冬艳. 146例早产妇治疗分析. 医学文选, 2005, 24(4): 548~549.
- 43. 梁淑花. 硫酸舒喘灵治疗45例先兆早产疗效观察. 航空航天医药, 2004, (1): 37.Liang SH. Effect of albuterol sulfate treatment premature labor of 45 Cases. Aerospace Medicine, 2004, (1): 37.
- 44. 陈建宗, 曹珍修, 吴味辛. 先兆早产宫缩抑制剂治疗63例分析. 重庆医药, 1990, 19(3): 19~20.
- 45. Jannet D, Abankwa A, Guyard B, et al. Nicardipine versus salbutamol in the treatment of premature labor. A prospective randomized study. Eur J Obstet Gynecol Reprod Biol, 1997, 73(1): 11-16.
- 46. French/Australian Atosiban Investigators Group. Treatment of preterm labor with the oxytocin antagonist atosiban: a double-blind, randomized, controlled comparison with salbutamol. Eur J Obstet Gynecol Reprod Biol, 2001, 98(2): 177-185.
- 47. Bisits A, Madsen G, Knox M, et al. The Randomized Nitric Oxide Tocolysis Trial (RNOTT) for the treatment of preterm labor.
- 48. Anotayanonth S, Subhedar NV, Garner P, et al. Betamimetics for inhibiting preterm labour. Cochrane Database Syst Rev, 2004, (4): CD004352.