Maternal antihypertensive drugs may influence cerebral oxygen extraction in preterm infants during the first days after birth

Abstract

Objective: To determine whether maternal antihypertensive drugs influenced cerebral oxygenation in preterm infants during the first days after birth.

Methods: We included 49 preterm infants (median gestational age 30.3 weeks, (range 26.0–31.9), birth weight 1250 g (560–2250)). Regional cerebral oxygen saturation (r_cSO₂) was measured by near-infrared spectroscopy on postnatal days 1, 2, 3, 4 and 5. Fractional tissue oxygen extraction (FTOE) was calculated using r_cSO₂ and arterial oxygen saturation (SpO₂) values:(SpO₂ − r_cSO₂)/SpO₂.

Results: Nine mothers were treated with labetalol and/or MgSO₄ during pregnancy, three mothers with labetalol, MgSO₄ and nifedipine, and 19 mothers with nifedipine only. Eighteen infants served as controls. Multivariate linear regression analysis showed that exposure to labetalol and/or MgSO₄ during pregnancy decreased FTOE on day 1 after birth, while nifedipine did not.

Conclusions: Treating pregnant women with labetalol and/or MgSO₄ may influence cerebral oxygen extraction in their offspring shortly after birth.

• Cerebral oxygenation
• fractional tissue oxygen extraction
• maternal antihypertensive drugs
• near-infrared spectroscopy
• preterm infants

Acknowledgements

We greatly acknowledge the help of Joke Ravisé for data collection. We also greatly acknowledge the help of Dr Titia Brantsma – van Wulfften Palthe in Utrecht for correcting the English manuscript.