Prenatal exposure to ritodrine lowers risk of severe intracerebral hemorrhage in VLBW infants

המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-25 15:48:48 EDT (Reuters Health)

LONDON (Reuters Health) – Ritodrine tocolysis reduces the incidence of grade III to IV periventricular/intraventricular haemorrhage among premature infants with very low birthweight (VLBW), report investigators in Israel.

Dr. Z. Weintraub, of Carmel Medical Center in Haifa, and associates accessed the Israel National VLBW Infant Database to identify VLBW infants born between 1995 and 1998. Included in their study were 2013 infants who had not been exposed to tocolytic treatment, 341 exposed to magnesium sulphate, 263 to ritodrine, and 177 exposed to indomethacin.

As reported in the July issue of The Archives of Disease in Children: Fetal and Neonatal Edition, none of these infants was treated with more than one tocolytic agent. All were born at a gestational age of 24 to 32 weeks and underwent cranial ultrasonography during the first 4 weeks of life.

The incidence of severe hemorrhage was 15.1% in the nonexposed group, 5.3% in the ritodrine group, 10% in the magnesium sulphate group, and 13.0% in the indomethacin group. Multivariate analysis showed no significant effect of magnesium sulphate or indomethacin on the risk of severe hemorrhage.

However, infants exposed to ritodrine were at significantly lower risk of severe hemorrhage, with an odds ratio of 0.3 after adjustment for other variables. "The percentage of severe intraventricular hemorrhage in infants whose mothers received ritodrine tocolysis was lower" than that among the remaining infants, the investigators write, and the trend was observed in "all gestational age, birth weight, and antenatal steroid treatment groups."

Arch Dis Child Fetal Neonatal Ed 2001;85:F13-F17.

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