title: The combined maternal administration of magnesium sulfate and aminophylline reduces intraventricular hemorrhage in very preterm neonates.
abstract: 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.
authors.affiliation: Centre of Perinatal and Reproductive Medicine, Neonatal Intensive Care Unit, University of Perugia, Perugia, Italy. direnzo@unipg.it
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Di Renzo
authors.forename: Marcella
authors.initials: M
authors.lastname: Mignosa
authors.forename: Sandro
authors.initials: S
authors.lastname: Gerli
authors.forename: Liliana
authors.initials: L
authors.lastname: Burnelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Luzi
authors.forename: Graziano
authors.initials: G
authors.lastname: Clerici
authors.forename: Fabiana
authors.initials: F
authors.lastname: Taddei
authors.forename: Doretta
authors.initials: D
authors.lastname: Marinelli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Bragetti
authors.forename: Daniele
authors.initials: D
authors.lastname: Mezzetti
authors.forename: Benedetta
authors.initials: B
authors.lastname: Della Torre
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fantauzzi
authors.forename: Maria Serena
authors.initials: MS
authors.lastname: Lungarotti
mesh_terms: 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
chemical_list: D018696:Neuroprotective Agents; D000628:Aminophylline; D008278:Magnesium Sulfate