Effect of dual tocolysis on the incidence of severe intraventricular hemorrhage among extremely low-birth-weight infants

• Published in: American journal of obstetrics and gynecology Vol. 175; no. 4; pp. 1043 - 1046
• Main Authors: Iannucci, Thomas A., Besinger, Richard E., Fisher, Susan G., Gianopoulos, John G., Tomich, Paul G.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.10.1996; Elsevier
• Subjects: Biological and medical sciences; Cerebral Hemorrhage - chemically induced; Cerebral Hemorrhage - epidemiology; Cerebral Ventricles - blood supply; Drug Therapy, Combination; Drug toxicity and drugs side effects treatment; extremely low birth weight; Female; Humans; Incidence; indomethacin; Indomethacin - adverse effects; Indomethacin - therapeutic use; Infant, Low Birth Weight; Infant, Newborn; intraventricular hemorrhage; Magnesium Sulfate - adverse effects; Magnesium Sulfate - therapeutic use; Medical sciences; Pharmacology. Drug treatments; Pregnancy; Premature labor; Regression Analysis; Retrospective Studies; tocolytic; Tocolytic Agents - adverse effects; Tocolytic Agents - therapeutic use; Toxicity: blood; tocolytic; intraventricular hemorrhage; extremely low birth weight; Premature labor; indomethacin; Human; Intracranial; Nervous system diseases; Magnesium sulfate; Pregnancy disorders; Indometacin; Low birth weight; Premature delivery; Cardiovascular disease; Cerebral ventricle; Hemorrhage; Tocolytic; Incidence; Vascular disease; Newborn diseases; Chemotherapy; Newborn; Treatment; Risk factor; Indoleacetic acid derivatives; Combined treatment; Cerebrovascular disease
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(96)80050-0

OBJECTIVE: Our purpose was to evaluate the null hypothesis that dual tocolysis with magnesium sulfate and indomethacin does not alter the rate of grade III or IV intraventricular hemorrhage. STUDY DESIGN: Fifty-six neonates weighing 500 to 800 gm from mothers who received tocolytic therapy with magnesium sulfate alone or in combination with indomethacin were the subjects of this retrospective study. Demographic variables were evaluated with a Student t test, χ2 analysis, Fisher exact test, or Mantel-Haenszel χ2 as appropriate. RESULTS: There was an increased incidence of grade III to IV intraventricular hemorrhage among patients treated with dual therapy (p = 0.02). Logistic regression showed that fetal age and dual tocolysis with indomethacin were the only independent prognostic factors for severe intraventricular hemorrhage. CONCLUSION: The results indicate that dual tocolysis with indomethacin may place extremely low-birth-weight infants at increased risk for grade III to IV intraventricular hemorrhage. (Am J Obstet Gynecol 1996;175:1043-6.)