Studies show a heightened need for risk/benefit analysis of terbutaline to treat pre-term labor.

Terbutaline, a beta 2-adrenergic agonist bronchodilator has been used off label to treat preterm labor since 1976. In the past 35 years there has been increasing evidence that obstetrical use of terbulaline is not without risks of serious side effects. As early as 1997 the FDA published concerns of long-term use and out of hospital use of terbutaline due to cardiovascular complications. As of 2009 there have been at least 12 documented cases of severe detrimental cardiovascular side effects related to the obstetrical use of terbutaline since the FDA’s initially warning. In 2004, a study from Duke University found that the obstetrical use of terbutaline increased the likelihood and degree of damage from frequently present environmental chemicals to an exposed child’s neurologic system later in life. Then in 2009 a study published in American Journal of Obstetrics & Gynecology found a correlation between treatment of women with preterm labor with beta 2-adrenergic agonists and increased risk of autism in their children. It is believed that during the second and third trimester these medications can “permanently alter the balance of sympathetic and parasympathetic tone in the individual.” In Februrary of this year (2011) the U.S. Department of Health issued a press release regarding the FDA’s decision to give terbutaline a Boxed Warning and Contraindication. According to the U.S. Department of Health there is not even enough evidence “that the use of terbulatine to prevent preterm labor improves infant outcomes.” According to the FDA the risks, of using terbutaline, to the patient(s) should be weighed against any benefits and its use is actually discouraged.

Mechcatie, Elizabeth. (2011). FDA warns about CV risks of obstetric terbutaline use. Family Practice News 41.5 (44). doi: A254482862

NewsRx Health & Science. (2009). Treatments for asthma and pre-term labor may increase risk of autism in developing fetus. NewsRx Health & Science. (202). doi:A214064315

Pre-term labor drug sensitizes brain to pesticide injury. (2004). Medical Letter on the CDC & FDA (45). doi: A115414610

USA: FDA warns against certain uses of asthma drug terbutaline for preterm labor. (2011). Right Vision News. doi: A249500309