Trial reportBJOG : an international journal of obstetrics and gynaecology2026
School Performance After Maintenance Tocolysis With Nifedipine for Threatened Preterm Birth: 12-Year Follow-Up of the APOSTEL 2 Trial.
Trial report in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate school performance at 12 years of age in children prenatally exposed to maintenance tocolysis with nifedipine versus placebo.
design12-year follow-up of the multicentre APOSTEL 2 trial, in which participants with threatened preterm birth between 26
settingThe APOSTEL 2 trial was conducted in 11 Dutch hospitals from 2008 to 2010. School outcomes were assessed at age 12.
participantsChildren from singleton and multiple pregnancies born to APOSTEL 2 participants.
methodsSchool performance data were received through linkage with a national registry (Statistics Netherlands).
main outcome measuresA high track recommendation for secondary school, adjusted for maternal education level, socioeconomic status, and child's biological sex.
resultsOf 492 eligible children, 357 were included (follow-up rate 73%). In the nifedipine group, significantly fewer children received a high track recommendation for secondary school, 67/189 (35.4%), compared to 74/168 (44.0%) in the placebo group (adjusted risk ratio (aRR) 0.76; 95% confidence interval (CI) 0.61-0.95). Outcomes were significantly poorer in children with the longest nifedipine exposure (9-14 days) compared to those not exposed (aRR 0.58; 95% CI 0.41-0.83).
conclusionsChildren prenatally exposed to maintenance tocolysis with nifedipine had significantly poorer school performance at 12 years of age compared to those exposed to placebo. These findings further discourage nifedipine's use for maintenance tocolysis, and more research is warranted regarding its long-term effects on child development.
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