Evidence map›Paper›PMID 38341578›Full record

SynthesisBMC pediatrics2024

Efficient administration of a combination of nifedipine and sildenafil citrate versus only nifedipine on clinical outcomes in women with threatened preterm labor: a systematic review and meta-analysis.

Elham Manouchehri, Somayeh Makvandi, Mahdieh Razi, Maryam Sahebari, Mona Larki

RetractedOpen access · goldAbstract readMeta-AnalysisSystematic ReviewRetracted Publication
In one paragraph

Synthesis in BMC pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Publishers' Response to Post-Publication Concerns About Clinical Research in Women's Health.BJOG : an international journal of obstetrics and gynaecology · 2025
    Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Elham ManouchehriRheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Somayeh MakvandiMenopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.ORCID 0000-0002-6351-1372
Mahdieh RaziDepartment of Pediatrics, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.ORCID 0000-0003-2891-4333
Maryam SahebariRheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Mona LarkiNursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. mona.larki66@gmail.com.
Mashhad University of Medical Sciences · IRAhvaz Jundishapur University of Medical Sciences · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreterm labor (PTL) is a common and serious pregnancy disorder that can cause long-term neurological issues in the infant. There are conflicting studies concerning whether sildenafil citrate (SC) reduces preterm labor complications. Therefore, the meta-analysis aimed to examine the clinical outcomes in women with threatened PTL who received nifedipine plus SC therapy versus only nifedipine.

methodsFor the original articles, six databases were searched using relevant keywords without restriction on time or language until January 13, 2024. The Cochrane risk-of-bias tool for randomized trials (RoB) and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) were both used to assess the risk of bias in randomized and non-randomized studies, and GRADE determined the quality of our evidence. Meta-analysis of all data was carried out using Review Manager (RevMan) version 5.1.

resultsSeven studies with mixed quality were included in the meta-analysis. The study found that combining nifedipine and SC resulted in more prolongation of pregnancy (MD = 6.99, 95% CI: 5.32, 8.65, p < 0.00001), a lower rate of delivery in the 1st to 3rd days after hospitalization (RR = 0.62, 95% CI: 0.50, 0.76, p < 0.00001), a higher birth weight (252.48 g vs. nifedipine alone, p = 0.02), and the risk ratio of admission to the neonatal intensive care unit (NICU) was significantly lower (RR = 0.62, 95% CI: 0.50, 0.76, p < 0.00001) compared to nifidepine alone. The evidence was high for prolongation of pregnancy, delivery rate 24-72 h after admission, and NICU admission, but low for newborn birth weight.

conclusionsGiven the effectiveness of SC plus nifedipine in increased prolongation of pregnancy and birth weight, lower delivery in the 1st to 3rd days after hospitalization, and NICU admission, Gynecologists and obstetricians are suggested to consider this strategy for PTL management, although additional article rigor is required to improve the quality of the evidence.

Indexed as

Drug Therapy, CombinationNifedipineObstetric Labor, PrematureSildenafil CitrateFemaleHumansInfant, NewbornPregnancyTocolytic AgentsTreatment OutcomeNifedipineSildenafil CitrateTocolytic AgentsMeta-analysisNifedipinePreterm laborSildenafil citrateSystematic review

Identifiers

PMID38341578
PMCPMC10858564
OpenAlexW4391721988

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.