Antenatal Phenobarbital to Prevent or Minimize Intraventricular Hemorrhage in the Low-Birthweight Neonate

Abstract

OBJECTIVE:

To review the evidence that antenatal phenobarbital can reduce the incidence or severity of periventricular-intraventricular hemorrhage (PIVH) in low-birthweight neonates.

DATA SOURCES:

MEDLINE searches were conducted with fan searches of all papers.

STUDY SELECTION:

Emphasis was placed on human data supplemented by relevant animal data.

DATA SYNTHESIS:

The barbiturates have been used to reduce hypoxic-ischemic cerebral events. Giving phenobarbital to high-risk pregnant women allows the drug to be in therapeutic concentrations during the critical period when PIVH occurs in low-birthweight infants. Current data suggest that antenatal phenobarbital can decrease the severity of PIVH; fewer data are available stating that it can decrease the incidence of PIVH.

CONCLUSIONS:

Evidence supports the hypothesis that antenatal phenobarbital is effective in decreasing the severity of PIVH in low-birthweight neonates. Further data are necessary regarding the incidence of low Apgar scores and respiratory depression in neonates given antenatal phenobarbital.