Influence of maternal magnesium sulphate and ritodrine treatment on the neonate: a study with six-month follow-up

Magnesium sulphate and ritodrine are commonly used drugs in the prevention of preterm delivery. However, the effects of these treatments on the newbor n are controversial. It has previously been suggested that antenatal tocoly tic magnesium sulphate decreases the incidence of cerebral palsy, but incre ases paediatric mortality. On the other hand, antenatal ritodrine treatment has been reported to increase the incidence of neonatal peri-intra-ventric ular haemorrhage (PIVH). We investigated the cerebral ultrasonographic find ings, neurological outcome and apparent life-threatening events (ALTE) amon g 63 infants, born before 33 wk of gestation, whose mothers were antenatall y treated for premature birth with ritodrine or magnesium sulphate, and for pre-eclampsia with magnesium sulphate. Cerebral ultrasonography was perfor med during the first week of life and repeated before hospital discharge. T he pathological findings were confirmed by a paediatric radiologist. A paed iatrician and a physiotherapist performed the neurological follow-up examin ation of the survivors at 6 mo of age. We found Grade 3-4 PIVH in 15% of th e infants exposed to maternal ritodrine treatment, in 9% of the infants who se mothers received tocolytic magnesium treatment, and in none of those exp osed to maternal magnesium treatment for pre-eclampsia (p = 0.19). However, no differences were observed in 6-mo development or in the rate of paediat ric mortality and ALTE among these three study groups. Because of the retro spective design and the limited number of subjects, the results of this stu dy must be interpreted with caution.