Hudalla Hannes, Bruckner Thomas, Pöschl Johannes, Strowitzki Thomas, Kuon Ruben-J
Department of Neonatology, Heidelberg University Hospital, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany.
Arch Gynecol Obstet. 2020 Mar;301(3):687-692. doi: 10.1007/s00404-020-05463-z. Epub 2020 Feb 28.
Despite safety concerns, β-sympathomimetics are still widely used as tocolytic agents. β-Blockers in turn are used to treat vasculo-proliferative diseases of the newborn such as retinopathy of prematurity (ROP), which may lead to visual impairment and blindness. The scope of this study was to investigate whether antenatal exposure to the β-sympathomimetic fenoterol contributes to the development of ROP.
For this single-center retrospective case-control study of prospectively collected clinical data, all infants born before 32 weeks of gestation between 2001 and 2012 were included. The association of prenatal exposure to fenoterol and the development of ROP were analyzed by multivariate logistic regression.
n = 1134 infants < 32 weeks of gestation were screened for eligibility, out of which n = 722 met the inclusion criteria. Exposure to fenoterol (n = 505) was not associated with a higher rate of ROP (OR 0.721, 95% CI 0.463-1.122). Further, duration of exposure (days) did not alter the incidence of ROP (OR 1.001, 95% CI 0.986-1.016). Frequency distribution of different ROP stages and the need for therapeutic intervention was also not affected by prenatal exposure to fenoterol. Risk factors for the development of ROP like low birth weight, low gestational age, prolonged respiratory support and multiple gestation were confirmed in our large study cohort.
β-Sympathomimetic tocolysis does not increase the rate of ROP in premature infants born < 32 weeks of gestation. Our results render fenoterol a safe tocolytic agent regarding neonatal ROP development.
尽管存在安全问题，β-拟交感神经药仍被广泛用作宫缩抑制剂。相反，β-阻滞剂用于治疗新生儿血管增生性疾病，如早产儿视网膜病变（ROP），这可能导致视力损害和失明。本研究的目的是调查产前暴露于β-拟交感神经药非诺特罗是否会导致ROP的发生。
对于这项前瞻性收集临床数据的单中心回顾性病例对照研究，纳入了2001年至2012年间所有孕32周前出生的婴儿。通过多因素逻辑回归分析产前暴露于非诺特罗与ROP发生之间的关联。
筛查了n = 1134例孕周<32周的婴儿是否符合纳入标准，其中n = 722例符合纳入标准。暴露于非诺特罗（n = 505）与较高的ROP发生率无关（比值比0.721，95%置信区间0.463 - 1.122）。此外，暴露持续时间（天数）并未改变ROP的发生率（比值比1.001，95%置信区间0.986 - 1.016）。不同ROP阶段的频率分布以及治疗干预的需求也不受产前暴露于非诺特罗的影响。在我们的大型研究队列中证实了ROP发生的危险因素，如低出生体重、低孕周、延长的呼吸支持和多胎妊娠。
β-拟交感神经药宫缩抑制不会增加孕周<32周的早产儿ROP发生率。我们的结果表明，就新生儿ROP的发生而言，非诺特罗是一种安全的宫缩抑制剂。
