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Maternal antihypertensive drugs may influence cerebral oxygen extraction in preterm infants during the first days

Elise A Verhagen1, Elisabeth M W Kooi, Paul P van den Berg

  • 1Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. e.a.verhagen@umcg.nl

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|January 22, 2013
PubMed

Insights

Maternal use of labetalol and magnesium sulfate during pregnancy may affect cerebral oxygen extraction in preterm infants shortly after birth. Nifedipine did not show a similar effect on infant cerebral oxygenation.

Area of Science:

  • Neonatal physiology
  • Pharmacology
  • Perinatal medicine

Background:

  • Preterm infants are at risk for altered cerebral oxygenation.
  • Maternal antihypertensive medications are commonly used during pregnancy.
  • The impact of these medications on neonatal cerebral oxygenation requires further investigation.

Purpose of the Study:

  • To investigate the influence of maternal antihypertensive drugs on cerebral oxygenation in preterm infants.
  • To assess regional cerebral oxygen saturation (rcSO2) and fractional tissue oxygen extraction (FTOE) in neonates exposed to specific maternal medications.

Main Methods:

  • A cohort of 49 preterm infants (median gestational age 30.3 weeks) was studied.
  • Regional cerebral oxygen saturation (rcSO2) was measured using near-infrared spectroscopy on postnatal days 1-5.
  • Fractional tissue oxygen extraction (FTOE) was calculated using rcSO2 and SpO2.

Main Results:

  • Infants born to mothers treated with labetalol and/or MgSO4 showed decreased FTOE on day 1.
  • Maternal nifedipine treatment did not significantly alter infant FTOE.
  • Multivariate analysis confirmed these findings in relation to maternal medication exposure.

Conclusions:

  • Maternal treatment with labetalol and/or MgSO4 may positively influence cerebral oxygen extraction in preterm neonates.
  • Nifedipine did not demonstrate a similar effect on early neonatal cerebral oxygenation.
  • These findings suggest a potential short-term benefit of certain antihypertensives on neonatal brain oxygenation.
Abstract

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