Neonatal haemodynamic effects following foetal exposure to labetalol in hypertensive disorders of pregnancy.
OBJECTIVE
Hypertensive disorders of pregnancy (HDP) affect foetal outcome. Labetalol is frequently used to lower maternal blood pressure and prolong pregnancy. Conflicting evidence exists for specific neonatal side effects described after maternal labetalol treatment. Our aim was to investigate neonatal effects of foetal exposure to labetalol on cerebral oxygenation and extraction.


METHODS
In a prospective observational study, clinical characteristics, vital parameters and cerebral oxygen delivery and extraction were collected during the first 24 h of life in labetalol-exposed preterm neonates and compared with two control groups.


RESULTS
Twenty-two infants with a mean gestational age of 28.9 weeks, born from labetalol-treated mothers with HDP were included and matched with 22 infants with non-labetalol-treated mothers with HDP and 22 infants without maternal HDP. No significant differences between groups were found neither in heart rate, blood pressure and inotropic support, nor in mean regional cerebral oxygen saturation and fractional tissue oxygen extraction.


CONCLUSIONS
Foetal labetalol exposure associated effects on preterm heart rate, blood pressure, cerebral oxygenation and extraction are not demonstrated. Maternal disease severity seems to play a more important role in neonatal cerebral haemodynamics. Maternal labetalol treatment has no clinically important short term side effects in the preterm neonate.
a Department of Neonatology and.
Liesbeth
L
Thewissen
b Department of Perinatology , University Medical Center Utrecht , Utrecht , Netherlands , and.
Lou
L
Pistorius
a Department of Neonatology and.
Wim
W
Baerts
c Department of Neonatology , University Hospitals Leuven , Leuven , Belgium.
Gunnar
G
Naulaers
a Department of Neonatology and.
Frank
F
Van Bel
a Department of Neonatology and.
Petra
P
Lemmers
D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects*; D016022:Case-Control Studies; D054022:Cerebrum / Q000187:drug effects; D005260:Female; D005865:Gestational Age; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D007741:Labetalol / Q000009:adverse effects*; D010101:Oxygen Consumption / Q000187:drug effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced; D011446:Prospective Studies; D013997:Time Factors
D000959:Antihypertensive Agents; D007741:Labetalol
cerebral oxygenation; hypertension pregnancy-induced; infant; newborn; β blocker