title: High-dose phenobarbital or erythropoietin for the treatment of perinatal asphyxia in term newborns.
abstract: BACKGROUND
  The aim of this study was to compare two neuroprotective strategies to supportive care in the treatment of perinatal asphyxia.
  
  
  METHODS
  A total of 67 term newborns with perinatal asphyxia were included and randomized into three groups: one group received supportive treatment; another group received a single dose of 40 mg/kg phenobarbital; and the third received three daily doses of 1000 IU/kg erythropoietin. The following parameters were analyzed: gestational age, birthweight, Apgar scores, cord blood pH, total serum antioxidant status (TAS), superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA). The newborns were included in the follow-up program and examined up to 18 months of age.
  
  
  RESULTS
  TAS was higher in the erythropoietin group than in the other groups. SOD and GPx were lower for infants treated with phenobarbital or erythropoietin compared to control infants. MDA was lower in the erythropoietin group compared to the other groups, although the difference was not statistically significant (P > 0.05). The mortality rate was lower in the phenobarbital and erythropoietin groups (both 4.6%) than in the control group (17.4%). Long-term neurologic follow up showed a high incidence of sequelae in the control group compared to the phenobarbital and erythropoietin groups. Follow-up results were better in the phenobarbital group than in the erythropoietin group for motor and cognitive function at 3 and 6 months and worse for expressive language. At 18 months, however, the differences between these two groups were not significant.
  
  
  CONCLUSIONS
  High-dose phenobarbital or erythropoietin along with supportive treatment has a positive influence on the outcome of newborns with perinatal asphyxia. Phenobarbital has the advantage of low cost and simplicity.
authors: Department of Mother and Child Care, Gr.T.Popa University of Medicine and Pharmacy, Iasi, Romania.
authors: Andreea
authors: A
authors: Avasiloaiei
authors: Cristina
authors: C
authors: Dimitriu
authors: Mihaela
authors: M
authors: Moscalu
authors: Luminita
authors: L
authors: Paduraru
authors: Maria
authors: M
authors: Stamatin
mesh_terms: D001238:Asphyxia Neonatorum / Q000188:drug therapy* / Q000378:metabolism; D001724:Birth Weight; D004305:Dose-Response Relationship, Drug; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006397:Hematinics / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007231:Infant, Newborn; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects; D010634:Phenobarbital / Q000008:administration & dosage*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D006993:Hypnotics and Sedatives; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa; D010634:Phenobarbital
keywords: erythropoietin; high-dose phenobarbital; neuroprotective strategies; oxidative stress; perinatal asphyxia