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Published on: May 28, 2019
[Tocolysis with calcium-channel blockers and intraventricular hemorrhage]
B Nguon1, V Zupan-Simunek, F Audibert
1Hôpital Antoine-Béclère, 157, Rue de la Porte-de-Trivaux, Clamart Cedex, France. benedicte.nguon@voila.fr
Insights
This study found no significant link between calcium-channel blockers used for tocolysis and intraventricular hemorrhage (IVH) risk in premature infants under 30 weeks. Further analysis confirmed no increased IVH risk with these tocolytic agents.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Obstetrics
Context:
- Premature infants (<30 weeks) face significant risks, including intraventricular hemorrhage (IVH).
- Tocolytic agents are used to inhibit premature labor, but their safety profiles require careful evaluation.
- Understanding the potential impact of specific tocolytics, like calcium-channel blockers, on neonatal outcomes is crucial.
Purpose:
- To investigate the association between maternal use of calcium-channel blockers as tocolytics and the incidence of intraventricular hemorrhage (IVH) in very premature infants.
- To compare the exposure frequency of calcium-channel blockers and other tocolytics in infants with and without IVH.
Summary:
- A case-control study compared 51 premature infants with IVH to 112 without, all under 30 weeks gestational age and from spontaneous births.
- While initial analysis suggested a link between combined tocolytic therapies (including calcium-channel blockers) and IVH, this association was not significant after adjusting for gestational age.
- No statistically significant association was found between calcium-channel blockers used as tocolytics and an increased risk of intraventricular hemorrhage in this cohort.
Impact:
- This research provides valuable data for obstetric and neonatal clinicians regarding the safety of calcium-channel blockers in preventing preterm birth.
- Findings may inform clinical guidelines on tocolytic use in pregnancies at risk of extreme preterm delivery.
- Contributes to the evidence base for managing risks associated with prematurity and its interventions.
Objective:
To determine the possible association between intraventricular hemorrhage (IVH) in very premature infants and calcium-channel blockers used as tocolytics.
Materials And Methods:
We performed a case-control study (from October 1999 to December 2002) including 51 premature infants under 30 weeks with IVH (all grade) and 112 premature infants under 30 weeks without IVH. In this study only premature infants issued from spontaneous prematurity were included. The exposure frequency to calcium-channel blockers and to other tocolytics were compared between the two groups by univariate analysis and by logistic regression analysis.
Results:
Calcium-channel blockers were used in monotherapy before birth in 16% of infants without IVH and in 20% of infants with IVH (P=0.55). An exposure to a bitherapy or a tritherapy with a calcium-channel blocker and one or several other tocolytics has been found in 43% of infants with IVH and in 26% of infants without IVH (P<0.05). However this association disappears after adjustment for gestational age.
Conclusion:
We did not find a significant association between calcium-channel blockers used as tocolytics and an increased risk of intraventricular hemorrhage in premature infants less than 30 weeks.
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