Early postnatal allopurinol does not improve short-term outcome after severe birth asphyxia

Manon J.N.L. Benders ^1*, Arie F. Bos ², Carin M.A. Rademaker ³, Monique Rijken ⁴, Helen L. Torrance ⁵, Floris Groenendaal ⁵ and Frank van Bel ⁵

¹ Wilhelmina Children's Hospital / University Medical Center Utrecht, Netherlands
² Department of Neonatology, University Medical Center, Groningen, Netherlands
³ Department of Pharmacy, Wilhelmina Children's Hospital / University Medical Center Utrecht, Netherlands
⁴ Department of Neonatology, Wilhelmina Children's Hospital / Leiden University Medical Center, Netherlands
⁵ Department of Neonatology, Wilhelmina Children's Hospital / University Medical Center Utrecht, Netherlands

^* To whom correspondence should be addressed. E-mail: m.benders{at}azu.nl.

Accepted 12 January 2006

Abstract

An interim analysis in 32 severely asphyxiated infants participating in a randomized double-blind placebo controlled study in which postnatal allopurinol or a placebo (within 4 h after birth) was administered to reduce free radical -induced reperfusion/reoxygenation injury of the newborn brain. This analysis showed an unaltered (high) mortality and and morbidity in infants treated with allopurinol. It was hypothesized that postnatal allopurinol treatment started too late to reduce the early reperfusion-induced free radical surge. Allopurinol administration to the fetus with (imminent) hypoxia via the mother during labor may be more effective to reduce free radical-induced post-asphyxial brain damage.

Keywords: allopurinol, birth asphyxia, neuroprotection, reperfusion injury

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