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Tocolysis with the β-2-sympathomimetic hexoprenaline increases occurrence of infantile haemangioma in preterm infants
  1. Michael Mayer1,
  2. Alexander Minichmayr1,
  3. Franziska Klement2,
  4. Katarina Hroncek1,
  5. Dagmar Wertaschnigg2,
  6. Wolfgang Arzt2,
  7. Gabriele Wiesinger-Eidenberger1,
  8. Evelyn Lechner1
  1. 1Department of Neonatology, Children's and Maternity Hospital Linz, Linz, Austria
  2. 2Department of Perinatology, Children's and Maternity Hospital Linz, Linz, Austria
  1. Correspondence to Michael Mayer, Children's and Maternity Hospital Linz, Department of Neonatology, Linz 4020, Austria; michael.mayer{at}


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.

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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