RT Journal Article
SR Electronic
T1 Effect of maternal tocolysis on the incidence of severe periventricular/intraventricular haemorrhage in very low birthweight infants
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F13
OP F17
DO 10.1136/fn.85.1.F13
VO 85
IS 1
A1 Z Weintraub
A1 M Solovechick
A1 B Reichman
A1 A Rotschild
A1 D Waisman
A1 O Davkin
A1 A Lusky
A1 Y Bental
YR 2001
UL http://fn.bmj.com/content/85/1/F13.abstract
AB AIM To examine the relation between grade III–IV periventricular/intraventricular haemorrhage (PVH/IVH) and antenatal exposure to tocolytic treatment in very low birthweight (VLBW) premature infants.STUDY DESIGN The study population consisted of 2794 infants from the Israel National VLBW Infant Database, of gestational age 24–32 weeks, who had a cranial ultrasound examination during the first 28 days of life. Infants of mothers with pregnancy induced hypertension or those exposed to more than one tocolytic drug were excluded. Of the 2794 infants, 2013 (72%) had not been exposed to tocolysis and 781 (28%) had been exposed to a single tocolytic agent. To evaluate the effect of tocolysis and confounding variables on grade III–IV PVH/IVH, the χ2test, univariate analysis, and a logistic regression model were used.RESULTS Of the 781 infants (28%) exposed to tocolysis, 341 (12.2%) were exposed to magnesium sulphate, 263 (9.4%) to ritodrine, and 177 (6.3%) to indomethacin. The overall incidence of grade III–IV PVH/IVH was 13.4%. In the multivariate logistic regression analysis, the following factors were related significantly and independently to grade III–IV PVH/IVH: no prenatal steroid treatment, low gestational age, one minute Apgar score 0–3, respiratory distress syndrome, patent ductus arteriosus, mechanical ventilation, and pneumothorax. Infants exposed to ritodrine tocolysis (but not to the other tocolytic drugs) were at significantly lower risk of grade III–IV PVH/IVH after adjustment for other variables (odds ratio = 0.3; 95% confidence interval 0.2 to 0.6).CONCLUSION This study suggests that antenatal exposure of VLBW infants to ritodrine tocolysis, in contrast with tocolysis induced by magnesium sulphate or indomethacin, was associated with a lower incidence of grade III–IV PVH/IVH.