Tocolysis with the β-2-sympathomimetic hexoprenaline increases occurrence of infantile haemangioma in preterm infants
- Michael Mayer1,
- Alexander Minichmayr1,
- Franziska Klement2,
- Katarina Hroncek1,
- Dagmar Wertaschnigg2,
- Wolfgang Arzt2,
- Gabriele Wiesinger-Eidenberger1,
- Evelyn Lechner1
- 1Department of Neonatology, Children's and Maternity Hospital Linz, Linz, Austria
- 2Department of Perinatology, Children's and Maternity Hospital Linz, Linz, Austria
- Correspondence to Michael Mayer, Children's and Maternity Hospital Linz, Department of Neonatology, Linz 4020, Austria;
- Received 14 September 2011
- Accepted 1 April 2012
- Published Online First 18 May 2012
Background Infantile haemangioma (IH) is the most commonly observed tumour in children. Off-label pharmacological treatment of IH with the beta-blocker propranolol induces regression of IH. Based on the fact that IH are more frequently observed in premature babies than in mature babies and the evidence that beta-blocker therapy leads to regression of IH, the authors generated the hypothesis that the use of β-2-sympathomimetics during pregnancy for inhibiting premature labour might increase occurrence of IH in preterm infants.
Methods For group comparison t test, Mann–Whitney U test and Fisher's exact test were used. Logistic regression was carried out by the forward stepwise method with Wald statistics.
Results Data of 328 preterm infants (<32 gestational weeks) or with a birth weight of less than 1500 g (<36 gestational weeks) born between January 2006 and December 2008 were analysed. A total of 15 were excluded due do death within the 1st month of life, 38 because of lost to follow-up and six due to incomplete data. Complete data of 269 preterm infants were retrospectively analysed. During the follow-up period of median 1.6 years, 50 infants developed one or more IH within their first 6 months of life. IH occurred in 40/181 patients with intrauterine exposure to the β-2-sympathomimetic hexoprenaline and in 10/88 without exposure (OR=4.3; 95% CI 1.4 to 13.8). Furthermore, the influence of antenatal exposure to glucocorticosteroids for induction of lung development was analysed. Prenatally exposed subjects showed reduced occurrence of IH (OR=0.2; 95% CI 0.05 to 0.8).
Conclusion Intrauterine exposure to the β-2-sympathomimetic hexoprenaline might increase the occurrence of IH in preterm infants.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.