The combined maternal administration of magnesium sulfate and aminophylline reduces intraventricular hemorrhage in very preterm neonates.
OBJECTIVE
To determine whether the adjunctive administration of aminophylline and magnesium sulfate to mothers at risk for preterm birth can reduce the rate of intraventricular hemorrhage in neonates born at less than 30 weeks of gestation.


METHODS
A prospective study was conducted to determine whether the rate of intraventricular hemorrhage was different in patients at risk for preterm delivery treated with ritodrine, magnesium sulfate, aminophylline, and corticosteroids (group A) versus patients treated with ritodrine and corticosteroids (group B). During the study period (January 1996 to December 2001), 125 patients enrolled in the study. Treatment was assigned by alternative allocation, and the study was designed to compare the rate of intraventricular hemorrhage in neonates born before the 30th week of gestation (primary outcome), 78 newborns in group A and 68 in group B. The proportion of neonates with intraventricular hemorrhage was calculated, and data were analyzed with Student t test, chi 2 , and logistic regression analysis.


RESULTS
The frequency of severe respiratory distress syndrome needing surfactant replacement and high-pressure positive ventilation, patent ductus arteriosus, and retinopathy of prematurity was not different between the 2 groups. However, the rate of intraventricular hemorrhage was lower in neonates born before 30 weeks whose mothers received adjunctive aminophylline and magnesium sulphate (group A) than in the group that did not receive these 2 agents (group B). The overall frequency of intraventricular hemorrhage was 5.1% (4/78) versus 20.6% (14/68) ( P < .001), and the frequency of intraventricular hemorrhage grade 3-4 was 1.3% (1/78) versus 10.3 % (7/68; P < .001), respectively.


CONCLUSIONS
Adjunctive maternal administration of aminophylline and magnesium sulfate was associated with a significant reduction in the rate of intraventricular hemorrhage in neonates born before 30 completed weeks.
Di Renzo
Gian Carlo
GC
Centre of Perinatal and Reproductive Medicine, Neonatal Intensive Care Unit, University of Perugia, Perugia, Italy. direnzo@unipg.it
Mignosa
Marcella
M
Gerli
Sandro
S
Burnelli
Liliana
L
Luzi
Giuseppe
G
Clerici
Graziano
G
Taddei
Fabiana
F
Marinelli
Doretta
D
Bragetti
Patrizia
P
Mezzetti
Daniele
D
Della Torre
Benedetta
B
Fantauzzi
Alessandra
A
Lungarotti
Maria Serena
MS
D000628:Aminophylline / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D020300:Intracranial Hemorrhages / Q000517:prevention & control*; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008297:Male; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D011247:Pregnancy; D011446:Prospective Studies
D018696:Neuroprotective Agents; D000628:Aminophylline; D008278:Magnesium Sulfate