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 newborn are controversial. It has previously been suggested that antenatal tocolytic magnesium sulphate decreases the incidence of cerebral palsy, but increases paediatric mortality. On the other hand, antenatal ritodrine treatment has been reported to increase the incidence of neonatal peri-intra-ventricular haemorrhage (PIVH). We investigated the cerebral ultrasonographic findings, neurological outcome and apparent life-threatening events (ALTE) among 63 infants, born before 33 wk of gestation, whose mothers were antenatally treated for premature birth with ritodrine or magnesium sulphate, and for pre-eclampsia with magnesium sulphate. Cerebral ultrasonography was performed during the first week of life and repeated before hospital discharge. The pathological findings were confirmed by a paediatric radiologist. A paediatrician and a physiotherapist performed the neurological follow-up examination of the survivors at 6 mo of age. We found Grade 3-4 PIVH in 15% of the infants exposed to maternal ritodrine treatment, in 9% of the infants whose mothers received tocolytic magnesium treatment, and in none of those exposed to maternal magnesium treatment for pre-eclampsia (p = 0.19). However, no differences were observed in 6-mo development or in the rate of paediatric mortality and ALTE among these three study groups. Because of the retrospective design and the limited number of subjects, the results of this study must be interpreted with caution.