Antenatal phenobarbital to prevent or minimize intraventricular hemorrhage in the low-birthweight neonate.

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.