The combined maternal administration of magnesium sulfate and aminophylline reduces intraventricular hemorrhage in very preterm neonates

• Published in: American journal of obstetrics and gynecology Vol. 192; no. 2; pp. 433 - 438
• Main Authors: Di Renzo, Gian Carlo, Mignosa, Marcella, Gerli, Sandro, Burnelli, Liliana, Luzi, Giuseppe, Clerici, Graziano, Taddei, Fabiana, Marinelli, Doretta, Bragetti, Patrizia, Mezzetti, Daniele, Torre, Benedetta Della, Fantauzzi, Alessandra, Lungarotti, Maria Serena
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.02.2005; Elsevier
• Subjects: Aminophylline; Aminophylline - administration & dosage; Biological and medical sciences; Corticosteroids; Diseases of mother, fetus and pregnancy; Drug Therapy, Combination; Female; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infant, Premature; Intracranial Hemorrhages - prevention & control; Intraventricular hemorrhage; Magnesium sulfate; Magnesium Sulfate - administration & dosage; Male; Medical sciences; Neurology; Neuroprotective Agents - administration & dosage; Pregnancy; Pregnancy. Fetus. Placenta; Preterm labor; Preterm premature rupture of membranes; Prospective Studies; Vascular diseases and vascular malformations of the nervous system; Preterm labor; Magnesium sulfate; Intraventricular hemorrhage; Corticosteroids; Preterm premature rupture of membranes; Aminophylline; Human; Premature; Corticosteroid; Nervous system diseases; Pregnancy disorders; Gynecology; Premature rupture of membrane; Premature delivery; Cardiovascular disease; Obstetrics; Cerebral disorder; Vascular disease; Newborn; Intraventricular hemorrhage Preterm labor Aminophylline Corticosteroids Magnesium sulfate Preterm premature rupture of membranes; Mother; Prematurity; Central nervous system disease; Delivery disorders; Xanthine derivatives; Cerebrovascular disease
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2004.07.078

To determine whether the adjunctive administration of aminophylline and magnesium sulfate to mothers at risk for preterm birth can reduce the rate of intraventricular hemorrhage in neonates born at less than 30 weeks of gestation. A prospective study was conducted to determine whether the rate of intraventricular hemorrhage was different in patients at risk for preterm delivery treated with ritodrine, magnesium sulfate, aminophylline, and corticosteroids (group A) versus patients treated with ritodrine and corticosteroids (group B). During the study period (January 1996 to December 2001), 125 patients enrolled in the study. Treatment was assigned by alternative allocation, and the study was designed to compare the rate of intraventricular hemorrhage in neonates born before the 30th week of gestation (primary outcome), 78 newborns in group A and 68 in group B. The proportion of neonates with intraventricular hemorrhage was calculated, and data were analyzed with Student t test, χ 2, and logistic regression analysis. The frequency of severe respiratory distress syndrome needing surfactant replacement and high-pressure positive ventilation, patent ductus arteriosus, and retinopathy of prematurity was not different between the 2 groups. However, the rate of intraventricular hemorrhage was lower in neonates born before 30 weeks whose mothers received adjunctive aminophylline and magnesium sulphate (group A) than in the group that did not receive these 2 agents (group B). The overall frequency of intraventricular hemorrhage was 5.1% (4/78) versus 20.6% (14/68) ( P < .001), and the frequency of intraventricular hemorrhage grade 3-4 was 1.3% (1/78) versus 10.3 % (7/68; P < .001), respectively. Adjunctive maternal administration of aminophylline and magnesium sulfate was associated with a significant reduction in the rate of intraventricular hemorrhage in neonates born before 30 completed weeks.