Does terbutaline damage the developing heart?
BACKGROUND
Beta(2)-Adrenoceptor (betaAR) agonists, such as terbutaline, are widely used to arrest preterm labor. They also cross the placenta where they stimulate receptors in fetal tissues, which in turn use betaAR input for trophic control of cell replication and differentiation.


METHODS
As rats are altricial, we administered terbutaline in two different postnatal exposure periods (10 mg/kg given daily on Days 2-5 or 11-14).


RESULTS
Hearts were examined twenty-four hours after the last dose and on postnatal day 30 for cardiac damage. Neither treatment paradigm caused an increase in cardiac abnormalities compared to controls but quantitative analysis of the number of nuclei indicated reductions in females.


CONCLUSIONS
These findings do not support earlier case reports of outright myocardial necrosis after terbutaline tocolysis in human infants. Nevertheless, the significant statistical association between terbutaline and cardiac anomalies in epidemiological studies suggest that terbutaline may sensitize the developing heart to other insults that affect development.
Rhodes
Melissa C
MC
Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Nyska
Abraham
A
Seidler
Frederic J
FJ
Slotkin
Theodore A
TA
D000318:Adrenergic beta-Agonists / Q000378:metabolism; D000818:Animals; D002467:Cell Nucleus / Q000378:metabolism; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000196:embryology*; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D011247:Pregnancy; D011270:Pregnancy, Animal; D051381:Rats; D011943:Receptors, Adrenergic, beta / Q000378:metabolism; D013726:Terbutaline / Q000494:pharmacology*; D013997:Time Factors; D015145:Tocolysis; D015149:Tocolytic Agents / Q000494:pharmacology*
D000318:Adrenergic beta-Agonists; D011943:Receptors, Adrenergic, beta; D015149:Tocolytic Agents; D013726:Terbutaline