Oral betamimetics for maintenance therapy after threatened preterm labour

Jodie M Dodd; Caroline A Crowther; Philippa Middleton

doi:10.1002/14651858.CD003927.pub3

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Analysis 1.1

Comparison 1 Betamimetic versus placebo/no treatment (primary outcomes), Outcome 1 Very preterm birth (Less than 34 weeks' gestation).

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Analysis 1.2

Comparison 1 Betamimetic versus placebo/no treatment (primary outcomes), Outcome 2 Low birthweight (< 2500 grams).

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Analysis 1.3

Comparison 1 Betamimetic versus placebo/no treatment (primary outcomes), Outcome 3 Neonatal intensive care unit admission.

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Analysis 1.4

Comparison 1 Betamimetic versus placebo/no treatment (primary outcomes), Outcome 4 Perinatal mortality.

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Analysis 2.1

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 1 Preterm birth (< 37 weeks).

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Analysis 2.2

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 2 Birthweight.

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Analysis 2.3

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 3 Respiratory distress syndrome.

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Analysis 2.4

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 4 Necrotising enterocolitis.

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Analysis 2.5

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 5 Intraventricular haemorrhage.

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Analysis 2.6

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 6 Neonatal jaundice.

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Analysis 2.7

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 7 Apgar score < 7 at 5 minutes.

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Analysis 2.8

Comparison 2 Betamimetic versus placebo/no treatment (infant outcomes), Outcome 8 Need for mechanical ventilation.

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Analysis 3.1

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 1 Side effects sufficient to stop therapy.

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Analysis 3.2

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 2 Tachycardia.

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Analysis 3.3

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 3 Tachypnoea.

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Analysis 3.4

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 4 Hypotension.

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Analysis 3.5

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 5 Nausea.

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Analysis 3.6

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 6 Vomiting.

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Analysis 3.7

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 7 Palpitations.

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Analysis 3.8

Comparison 3 Betamimetic versus placebo/no treatment (maternal outcomes), Outcome 8 Headache.

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Analysis 4.1

Comparison 4 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), Outcome 1 Preterm birth within 24 hours.

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Analysis 4.2

Comparison 4 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), Outcome 2 Preterm birth within 48 hours.

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Analysis 4.3

Comparison 4 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), Outcome 3 Preterm birth within 1 week.

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Analysis 4.4

Comparison 4 Betamimetic versus placebo/no treatment (preterm birth and hospital admissions), Outcome 4 Maternal antenatal readmission to hospital.

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Analysis 5.1

Comparison 5 Terbutaline versus indomethacin (primary outcomes), Outcome 1 Very preterm birth (< 34 weeks).

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Analysis 5.2

Comparison 5 Terbutaline versus indomethacin (primary outcomes), Outcome 2 Neonatal mortality.

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Analysis 6.1

Comparison 6 Terbutaline versus indomethacin (infant outcomes), Outcome 1 Birthweight.

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Analysis 6.2

Comparison 6 Terbutaline versus indomethacin (infant outcomes), Outcome 2 Required mechanical ventilation.

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Analysis 6.3

Comparison 6 Terbutaline versus indomethacin (infant outcomes), Outcome 3 Days stay in neonatal intensive care unit.

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Analysis 6.4

Comparison 6 Terbutaline versus indomethacin (infant outcomes), Outcome 4 Intraventricular haemorrhage.

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Analysis 7.1

Comparison 7 Terbutaline versus indomethacin (maternal outcomes), Outcome 1 Side effects sufficient to stop therapy.

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Analysis 8.1

Comparison 8 Terbutaline versus indomethacin (preterm birth and hospital admissions), Outcome 1 Preterm birth.

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Analysis 8.2

Comparison 8 Terbutaline versus indomethacin (preterm birth and hospital admissions), Outcome 2 Maternal antenatal readmission to hospital.

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Analysis 9.1

Comparison 9 Terbutaline versus ritodrine (primary outcomes), Outcome 1 Very preterm birth (less than 34 weeks).

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Analysis 10.1

Comparison 10 Terbutaline versus ritodrine (infant outcomes), Outcome 1 Preterm birth (< 37 weeks).

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Analysis 10.2

Comparison 10 Terbutaline versus ritodrine (infant outcomes), Outcome 2 Mean birthweight.

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Analysis 10.3

Comparison 10 Terbutaline versus ritodrine (infant outcomes), Outcome 3 Hyperbilirubinaemia (neonatal jaundice requiring phototherapy).

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Analysis 11.1

Comparison 11 Terbutaline versus ritodrine (maternal outcomes), Outcome 1 Tachycardia.

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Analysis 11.2

Comparison 11 Terbutaline versus ritodrine (maternal outcomes), Outcome 2 Tachypnoea.

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Analysis 11.3

Comparison 11 Terbutaline versus ritodrine (maternal outcomes), Outcome 3 Nausea/vomiting.

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Analysis 12.1

Comparison 12 Terbutaline versus ritodrine (preterm birth and hospital admissions), Outcome 1 Maternal antenatal readmission to hospital.

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Analysis 13.1

Comparison 13 Betamimetic versus magnesium (primary outcomes), Outcome 1 Neonatal intensive care unit admission.

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Analysis 13.2

Comparison 13 Betamimetic versus magnesium (primary outcomes), Outcome 2 Perinatal mortality.

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Analysis 14.1

Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 1 Preterm birth (< 37 weeks).

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Analysis 14.2

Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 2 Birthweight.

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Analysis 14.3

Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 3 Respiratory distress syndrome.

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Analysis 14.4

Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 4 Intraventricular haemorrhage.

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Analysis 14.5

Comparison 14 Betamimetic versus magnesium (infant outcomes), Outcome 5 Neonatal jaundice.

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Analysis 15.1

Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 1 Side effects sufficient to stop medication.

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Analysis 15.2

Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 2 Tachycardia/palpitations.

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Analysis 15.3

Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 3 Tachypnoea.

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Analysis 15.4

Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 4 Nausea.

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Analysis 15.5

Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 5 Vomiting.

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Analysis 15.6

Comparison 15 Betamimetic versus magnesium (maternal outcomes), Outcome 6 Chest pain.

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Analysis 16.1

Comparison 16 Betamimetic versus magnesium (preterm birth and hospital admissions), Outcome 1 Maternal antenatal readmission to hospital.

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Comparison 1. Betamimetic versus placebo/no treatment (primary outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Very preterm birth (Less than 34 weeks' gestation) Show forest plot	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	2.81 [0.30, 26.22]

1.1 Ritodrine versus placebo/no treatment	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	2.81 [0.30, 26.22]
2 Low birthweight (< 2500 grams) Show forest plot	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	0.15 [0.02, 1.25]

2.1 Ritodrine versus placebo/no treatment	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	0.15 [0.02, 1.25]
3 Neonatal intensive care unit admission Show forest plot	2	260	Risk Ratio (M‐H, Fixed, 95% CI)	1.28 [0.68, 2.41]

3.1 Ritodrine versus placebo/no treatment	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	1.25 [0.29, 5.34]
3.2 Terbutaline versus placebo/no treatment	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	1.29 [0.64, 2.60]
4 Perinatal mortality Show forest plot	6	681	Risk Ratio (M‐H, Fixed, 95% CI)	2.41 [0.86, 6.74]

4.1 Ritodrine versus placebo/no treatment	3	214	Risk Ratio (M‐H, Fixed, 95% CI)	1.85 [0.41, 8.39]
4.2 Terbutaline versus placebo/no treatment	3	467	Risk Ratio (M‐H, Fixed, 95% CI)	2.96 [0.72, 12.14]
5 Maternal death or serious maternal morbidity	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. Betamimetic versus placebo/no treatment (primary outcomes)

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Comparison 2. Betamimetic versus placebo/no treatment (infant outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Preterm birth (< 37 weeks) Show forest plot	6	644	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.91, 1.35]

1.1 Ritodrine versus placebo/no treatment	4	405	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.75, 1.57]
1.2 Terbutaline versus placebo/no treatment	2	239	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.89, 1.41]
2 Birthweight Show forest plot	7	780	Mean Difference (IV, Fixed, 95% CI)	4.13 [‐91.89, 100.16]

2.1 Ritodrine versus placebo/no treatment	2	110	Mean Difference (IV, Fixed, 95% CI)	‐136.61 [‐395.85, 122.63]
2.2 Terbutaline versus placebo/no treatment	5	670	Mean Difference (IV, Fixed, 95% CI)	26.52 [‐76.87, 129.90]
3 Respiratory distress syndrome Show forest plot	6	770	Risk Ratio (M‐H, Fixed, 95% CI)	1.10 [0.61, 1.98]

3.1 Ritodrine versus placebo/no treatment	3	303	Risk Ratio (M‐H, Fixed, 95% CI)	1.46 [0.57, 3.73]
3.2 Terbutaline versus placebo/no treatment	3	467	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.43, 1.98]
4 Necrotising enterocolitis Show forest plot	2	416	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.22, 4.28]

4.1 Terbutaline versus placebo/no treatment	2	416	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.22, 4.28]
5 Intraventricular haemorrhage Show forest plot	3	466	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.27, 3.58]

5.1 Ritodrine versus placebo/no treatment	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.13, 70.30]
5.2 Terbutaline versus placebo/no treatment	2	416	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.16, 3.24]
6 Neonatal jaundice Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.71, 3.89]

6.1 Ritodrine versus no treatment	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.71, 3.89]
7 Apgar score < 7 at 5 minutes Show forest plot	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.23 [0.05, 1.06]

7.1 Ritodrine versus placebo/no treatment	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.23 [0.05, 1.06]
8 Need for mechanical ventilation Show forest plot	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.06, 14.61]

8.1 Ritodrine versus placebo/no treatment	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.06, 14.61]

Comparison 2. Betamimetic versus placebo/no treatment (infant outcomes)

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Comparison 3. Betamimetic versus placebo/no treatment (maternal outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Side effects sufficient to stop therapy Show forest plot	2	141	Risk Ratio (M‐H, Fixed, 95% CI)	2.71 [0.11, 64.79]

1.1 Ritodrine versus placebo	1	95	Risk Ratio (M‐H, Fixed, 95% CI)	2.71 [0.11, 64.79]
1.2 Terbutaline versus placebo	1	46	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Tachycardia Show forest plot	4	414	Risk Ratio (M‐H, Fixed, 95% CI)	2.13 [1.52, 2.98]

2.1 Ritodrine versus placebo	3	368	Risk Ratio (M‐H, Fixed, 95% CI)	2.41 [1.59, 3.66]
2.2 Terbutaline versus placebo	1	46	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.86, 2.61]
3 Tachypnoea Show forest plot	2	260	Risk Ratio (M‐H, Fixed, 95% CI)	3.52 [1.20, 10.33]

3.1 Ritodrine versus placebo	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	4.21 [0.95, 18.67]
3.2 Terbutaline versus placebo	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	2.83 [0.59, 13.56]
4 Hypotension Show forest plot	2	166	Risk Ratio (M‐H, Fixed, 95% CI)	1.89 [1.13, 3.19]

4.1 Ritodrine versus placebo	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	2.81 [0.30, 26.22]
4.2 Terbutaline versus placebo	1	46	Risk Ratio (M‐H, Fixed, 95% CI)	1.8 [1.08, 3.01]
5 Nausea Show forest plot	2	186	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.43, 2.13]

5.1 Terbutaline versus placebo	2	186	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.43, 2.13]
6 Vomiting Show forest plot	2	235	Risk Ratio (M‐H, Fixed, 95% CI)	1.28 [0.44, 3.70]

6.1 Ritodrine versus placebo	1	95	Risk Ratio (M‐H, Fixed, 95% CI)	2.71 [0.11, 64.79]
6.2 Terbutaline versus placebo	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.36, 3.54]
7 Palpitations Show forest plot	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	5.67 [1.32, 24.40]

7.1 Terbutaline versus placebo	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	5.67 [1.32, 24.40]
8 Headache Show forest plot	1	95	Risk Ratio (M‐H, Fixed, 95% CI)	2.71 [0.11, 64.79]

8.1 Ritodrine versus placebo/no treatment	1	95	Risk Ratio (M‐H, Fixed, 95% CI)	2.71 [0.11, 64.79]

Comparison 3. Betamimetic versus placebo/no treatment (maternal outcomes)

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Comparison 4. Betamimetic versus placebo/no treatment (preterm birth and hospital admissions)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Preterm birth within 24 hours Show forest plot	1	46	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.12, 3.62]

1.1 Terbutaline versus placebo/no treatment	1	46	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.12, 3.62]
2 Preterm birth within 48 hours Show forest plot	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.30, 2.01]

2.1 Terbutaline versus placebo/no treatment	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.30, 2.01]
3 Preterm birth within 1 week Show forest plot	2	295	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.40, 1.13]

3.1 Ritodrine versus placebo	1	95	Risk Ratio (M‐H, Fixed, 95% CI)	0.23 [0.03, 1.94]
3.2 Terbutaline versus placebo	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.44, 1.29]
4 Maternal antenatal readmission to hospital Show forest plot	4	335	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.76, 1.62]

4.1 Ritodrine versus placebo/no treatment	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.50, 1.46]
4.2 Terbutaline versus placebo/no treatment	3	285	Risk Ratio (M‐H, Fixed, 95% CI)	1.27 [0.77, 2.10]

Comparison 4. Betamimetic versus placebo/no treatment (preterm birth and hospital admissions)

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Comparison 5. Terbutaline versus indomethacin (primary outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Very preterm birth (< 34 weeks) Show forest plot	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.64 [0.24, 1.76]

2 Neonatal mortality Show forest plot	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 5. Terbutaline versus indomethacin (primary outcomes)

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Comparison 6. Terbutaline versus indomethacin (infant outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Birthweight Show forest plot	1	65	Mean Difference (IV, Fixed, 95% CI)	52.0 [‐202.54, 306.54]

2 Required mechanical ventilation Show forest plot	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.34 [0.01, 8.13]

3 Days stay in neonatal intensive care unit Show forest plot	1	65	Mean Difference (IV, Fixed, 95% CI)	‐1.17 [‐2.93, 0.59]

4 Intraventricular haemorrhage Show forest plot	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 6. Terbutaline versus indomethacin (infant outcomes)

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Comparison 7. Terbutaline versus indomethacin (maternal outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Side effects sufficient to stop therapy Show forest plot	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	3.09 [0.13, 73.19]

Comparison 7. Terbutaline versus indomethacin (maternal outcomes)

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Comparison 8. Terbutaline versus indomethacin (preterm birth and hospital admissions)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Preterm birth Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

1.1 Within 48 hours	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 Within 1 week	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.26 [0.03, 2.18]
2 Maternal antenatal readmission to hospital Show forest plot	1	65	Risk Ratio (M‐H, Fixed, 95% CI)	0.60 [0.34, 1.05]

Comparison 8. Terbutaline versus indomethacin (preterm birth and hospital admissions)

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Comparison 9. Terbutaline versus ritodrine (primary outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Very preterm birth (less than 34 weeks) Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	0.29 [0.01, 6.86]

Comparison 9. Terbutaline versus ritodrine (primary outcomes)

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Comparison 10. Terbutaline versus ritodrine (infant outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Preterm birth (< 37 weeks) Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	0.8 [0.44, 1.46]

2 Mean birthweight Show forest plot	1	91	Mean Difference (IV, Fixed, 95% CI)	38.30 [‐210.97, 287.57]

3 Hyperbilirubinaemia (neonatal jaundice requiring phototherapy) Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	1.45 [0.84, 2.51]

Comparison 10. Terbutaline versus ritodrine (infant outcomes)

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Comparison 11. Terbutaline versus ritodrine (maternal outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Tachycardia Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	0.57 [0.22, 1.47]

2 Tachypnoea Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	2.57 [0.55, 12.07]

3 Nausea/vomiting Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	0.57 [0.17, 1.89]

Comparison 11. Terbutaline versus ritodrine (maternal outcomes)

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Comparison 12. Terbutaline versus ritodrine (preterm birth and hospital admissions)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Maternal antenatal readmission to hospital Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	1.71 [0.56, 5.29]

Comparison 12. Terbutaline versus ritodrine (preterm birth and hospital admissions)

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Comparison 13. Betamimetic versus magnesium (primary outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Neonatal intensive care unit admission Show forest plot	1	137	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.43, 1.46]

1.1 Terbutaline versus magnesium	1	137	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.43, 1.46]
2 Perinatal mortality Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.2 [0.01, 3.97]

2.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.2 [0.01, 3.97]

Comparison 13. Betamimetic versus magnesium (primary outcomes)

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Comparison 14. Betamimetic versus magnesium (infant outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Preterm birth (< 37 weeks) Show forest plot	2	100	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.58, 1.79]

1.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.54, 1.87]
1.2 Terbutaline versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.32, 3.50]
2 Birthweight Show forest plot	3	239	Mean Difference (IV, Fixed, 95% CI)	‐28.80 [‐187.41, 129.81]

2.1 Ritodrine versus magnesium	1	50	Mean Difference (IV, Fixed, 95% CI)	‐82.0 [‐464.19, 300.19]
2.2 Terbutaline versus magnesium	2	189	Mean Difference (IV, Fixed, 95% CI)	‐17.73 [‐192.06, 156.60]
3 Respiratory distress syndrome Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.19, 20.67]

3.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.19, 20.67]
4 Intraventricular haemorrhage Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.07, 15.12]

4.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.07, 15.12]
5 Neonatal jaundice Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.91 [0.47, 1.75]

5.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.91 [0.47, 1.75]

Comparison 14. Betamimetic versus magnesium (infant outcomes)

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Comparison 15. Betamimetic versus magnesium (maternal outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Side effects sufficient to stop medication Show forest plot	2	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.90 [0.24, 3.46]

1.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 5.17]
1.2 Terbutaline versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.28 [0.23, 7.00]
2 Tachycardia/palpitations Show forest plot	3	237	Risk Ratio (M‐H, Fixed, 95% CI)	5.61 [2.41, 13.04]

2.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	17.0 [1.03, 279.53]
2.2 Terbutaline versus magnesium	2	187	Risk Ratio (M‐H, Fixed, 95% CI)	4.54 [1.86, 11.07]
3 Tachypnoea Show forest plot	1	137	Risk Ratio (M‐H, Fixed, 95% CI)	1.35 [0.40, 4.59]

3.1 Terbutaline versus magnesium	1	137	Risk Ratio (M‐H, Fixed, 95% CI)	1.35 [0.40, 4.59]
4 Nausea Show forest plot	3	237	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.57, 1.98]

4.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 5.17]
4.2 Terbutaline versus magnesium	2	187	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.60, 2.19]
5 Vomiting Show forest plot	3	237	Risk Ratio (M‐H, Fixed, 95% CI)	0.88 [0.39, 1.98]

5.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Terbutaline versus magnesium	2	187	Risk Ratio (M‐H, Fixed, 95% CI)	0.88 [0.39, 1.98]
6 Chest pain Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

6.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 15. Betamimetic versus magnesium (maternal outcomes)

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Comparison 16. Betamimetic versus magnesium (preterm birth and hospital admissions)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Maternal antenatal readmission to hospital Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.60, 1.99]

1.1 Ritodrine versus magnesium	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.60, 1.99]

Comparison 16. Betamimetic versus magnesium (preterm birth and hospital admissions)

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