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.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
-
Gold ehem Ulrich Daniela
-
Pichler Gerhard
- Altmetrics:
- 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.