Extended-release nifedipine benefits women with severe pre-eclampsia

Treatment with extended-release nifedipine helps reduce intrapartum acute hypertensive therapy among pre-eclampsia patients with severe features, as reported in a study.

A total of 365 patients with pre-eclampsia and severe features undergoing labour induction between 220/7 and 416/7 weeks of gestation were screened into a randomized, triple-blind, placebo-controlled trial. Of these, 110 were included, with 55 allocated to the group treated with oral extended-release nifedipine 30 mg and the other 55 to identical placebo. Treatment was administered every 24 hours.

Researchers recorded the number of patients who received ≥1 dose of acute hypertension therapy for severe blood pressure (≥160/110 mm Hg) sustained ≥10 minutes, which was the primary endpoint. They also assessed route of delivery, neonatal intensive care unit admission, and a composite of adverse neonatal outcomes.

The primary endpoint occurred less frequently in the nifedipine group than in the placebo group (34.0 percent vs 55.1 percent; relative risk [RR], 0.62, 95 percent confidence interval [CI], 0.39–0.97). The corresponding number needed to treat to prevent receipt of acute treatment was 4.7 (95 percent CI, 2.5–44.3).

Furthermore, nifedipine treatment led to lower rates of required caesarean delivery (20.8 percent vs 34.7 percent; RR, 0.60, 95 percent CI, 0.31–1.15) and neonatal intensive care unit admission (29.1 percent vs 47.1 percent; RR, 0.62, 95 percent CI, 0.37–1.02).

Meanwhile, there was no significant between-group difference noted in the composite of adverse neonatal outcomes (35.8 percent with nifedipine vs 41.2 percent with placebo; RR, 0.83, 95 percent CI, 0.51–1.37).