Antenatal phenobarbital for the prevention of periventricular and
intraventricular hemorrhage: a double-blind, randomized, placebo-controlled,
multihospital trial.
Author(s): Kaempf JW, Porreco R, Molina R, Hale K, Pantoja AF, Rosenberg AA.
Affiliation(s): Department of Pediatrics, University of Colorado School of Medicine, Denver.
Publication date & source: 1990, J Pediatr. , 117(6):933-8
To determine whether the neuroprotective properties of phenobarbital would alter
the incidence and severity of intracranial hemorrhage in premature infants, we
randomly assigned 110 women at less than 31 weeks of gestation to receive 10
mg/kg phenobarbital or placebo in a blinded fashion before delivery. Infants were
examined postnatally with real-time ultrasonography for evidence of intracranial
hemorrhage. Maternal demographics, pregnancy complications, antenatal management,
and route of delivery did not differ between the phenobarbital group (n = 50) and
the placebo group (n = 60). The total incidence of
periventricular-intraventricular hemorrhage did not differ between the
phenobarbital-treated (n = 54) and the placebo-treated (n = 67) infants. However,
the frequency of grade 3 and grade 4 hemorrhages was 15% (10 infants) in the
placebo group and 3.7% (2 infants) in the phenobarbital group (p less than 0.05).
There were no differences in the severity of associated conditions in the babies
to explain the difference in the incidence of severe hemorrhage between the study
groups. We conclude that antenatal administration of phenobarbital appears to be
effective in decreasing the severity of periventricular-intraventricular
hemorrhage in infants delivered at less than 31 weeks of gestation.
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