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Antenatal phenobarbital therapy and neonatal outcome. II: Neurodevelopmental outcome at 36 months
S Shankaran1, E Woldt, J Nelson
1Department of Pediatrics, Children's Hospital of Michigan, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, 48201, USA.
Objective:
To evaluate the effect of antenatal phenobarbital (PB) therapy on neurodevelopmental outcome at 36 months.
Design:
Prospective, randomized, controlled trial.
Setting:
Single-institution study. SUBJECT AND INTERVENTIONS: Children born to women who participated in the study evaluating the effect of antenatal phenobarbital (PB) on neonatal intracranial hemorrhage were prospectively followed to 3 years of age.
Outcome Measures:
Physical growth, neurologic examinations, and developmental testing (McCarthy Scales of Children's Abilities). Comparisons between groups were made on all children and those born to multiple gestations.
Results:
Forty-one children born to women who received 10 mg/kg PB before delivery and 55 children in the control group were evaluated. Three children, all in the control group, had growth parameters (height, weight, and head circumference) below the fifth percentile. The McCarthy General Cognitive Index (standard, 100 +/- 16) was 93 +/- 20 in the PB group and 85 +/- 18 in the control group. The subscores tended to be higher in the PB group than in the control group, with higher quantitative scores in the PB group (44 +/- 11 vs 39 +/- 8). Neurologic deficits were noted in 2 of 41 in the PB group and in 6 of 55 in the control group.
Conclusions:
Infants born to women who received antenatal PB therapy had similar neurodevelopmental outcomes as infants born to women who did not receive PB. No adverse effects of PB exposure were detected.