Treatment of mothers with allopurinol to produce therapeutic blood levels in newborns

Objectives A number of experimental and clinical studies have shown that al lopurinol, a xanthine oxidase inhibitor, can reduce hypoxic-ischemic reperf usion injury, but only by preventive or early treatment, which is rarely po ssible in clinical circumstances. The aim of the present study was to evalu ate whether allopurinol administered to the mothers before the onset of lab or in animal experiments, or after the onset of labor in human studies, wou ld cross the placenta so as to establish a therapeutic level of allopurinol in newborns without affecting the process of delivery. Material and methods In randomized investigations, brood sows were treated with allopurinol prior to farrowing. In human studies, mothers with full-te rm or preterm pregnancies received a single dose of allopurinol orally imme diately after the onset of labor. Results In both animals and humans, the process of delivery and the postnat al events in the newborns were similar in the treated and the control group s. The free placental transfer of allopurinol and its metabolite oxypurinol led to the attainment of therapeutic blood levels in the resulting newborn piglets and human infants. Conclusions The placental transfer of allopurinol administered to parturien t mothers may be effective in starting the early treatment of newborns with a high risk of hypoxic-reperfusion cerebral damage.