Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

Tschabuschnig, K.
Neurological long-term outcome of premature infants after tocolysis between the 24th and 32nd week of gestation Comparison between standard- versus maintenance tocolysis with Atosiban and Hexoprenalin
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp. [OPEN ACCESS]
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Autor*innen der Med Uni Graz:
Betreuer*innen:
Gold ehem Ulrich Daniela
Pichler Gerhard
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Abstract:
Introduction Worldwide preterm birth is a major health problem. It is one main factor for neonatal deaths whereby premature delivery rates are rising. Fortunately medical support has made a lot of progress in neonatal care over the past decades and therefore also the numbers of survivors are rising. At the same time the effects on long-term outcome of infants has an increasing impact. Tocolytics have been used for a long time to prolong pregnancy but still there are few studies on the drug’s effect on the neonatal long term neurodevelopment. At the moment in Austria two medications are used for tocolysis: Hexoprenalin and Atosiban. Studies have shown that both are effective in delaying birth but Atosiban showed fewer side effects. There are few studies on the long-term neurodevelopmental outcome in regard to medication in premature infants. Material and methods In this retrospective study we analyzed the impact of the two tocolytics on the long-term neurodevelopment of preterm infants. Furthermore we compared the neurodevelopmental outcome of neonates whose mothers received standard or maintenance tocolysis. Maternal and neonatal data were retrieved from medical records of the University Hospital of Graz. We hypothesized that there is no difference in the outcome of neonates dependant on the tocolytic drug or type. The BSID-II was used to define neurodevelopmental outcome of infants at the age of 2 years. Results The statistical tests did not show any significant difference in the outcome of infants who were exposed to Hexoprenalin or Atosiban in utero. No effect on the neonatal long term development was seen between maintenance or standard tocolysis. It has to be noted that the validity of the test was impacted by the small number of infants included. Conclusion Tocolysis is frequently used to prolong pregnancy until the 34th week of gestation but could potentially harm mother and child. None of the used tocolytic agents or administration protocol used in our study was proven to be superior in regard to infantile neurodevelopmental outcome. Further trials with larger study population would be needed to evaluate the effects of tocolysis on the infantile long-term neurodevelopment.

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