Abstract
OBJECTIVE: To determine whether uterine tachysystole is associated with adverse neonatal and maternal outcomes. DATA SOURCES: A search strategy for PubMed (National Library of Medicine) was created, and the medical librarian translated the search for every database. The search strategy was peer reviewed by another medical librarian following the Peer Review of Electronic Search Strategies checklist. The databases included in this search were PubMed, Embase.com, Cochrane CENTRAL, CINAHL Ultimate, and Scopus; a combination of key words and subject headings was used. METHODS OF STUDY SELECTION: Trials of nulliparous or multiparous parturients exposed to uterine tachysystole were included. Included studies compared individuals with and those without uterine tachysystole. TABULATION INTEGRATION AND RESULTS: Two reviewers independently extracted data and assessed risk of bias. Random-effect head-to-head meta-analyses reporting summary odds ratios (ORs) with 95% CIs were performed. The random-effects model of DerSimonian and Laird was used. Values of I (2) (Higgins I (2)) greater than 50% were used to identify heterogeneity. The coprimary outcome was Apgar score below 7 at 5 minutes and umbilical arterial pH less than 7.10. Of 10,719 studies screened, five met the inclusion criteria with 68,412 individuals. Of these, 7,412 (10.9%) were exposed to uterine tachysystole, and 60,857 (89.1%) were unexposed. The likelihood of the coprimary outcomes was similar: Apgar score below 7 at 5 minutes (OR 1.11, 95% CI, 0.65-1.89) and umbilical arterial pH less than 7.10 (OR 1.38, 95% CI, 0.34-5.25). Nonsignificant differences were reported between the two groups for cesarean delivery (OR 0.68, 95% CI, 0.27-1.73), for Apgar score below 3 at 5 minutes (OR 0.46, 95% CI, 0.17-1.23), and for neonatal seizures (0.23% vs 0.17%, OR 1.27, 95% CI, 0.50-3.21). CONCLUSION: Observational studies do not report significant differences in the likelihood of adverse neonatal outcomes and cesarean delivery among individuals exposed compared with those not exposed to uterine tachysystole during labor. Additional data, from either interventional trials or observational studies with better characterization of the interventions and outcomes, on uterine tachysystole and adverse outcomes are needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42024560155.