High‐dose phenobarbital or erythropoietin for the treatment of perinatal asphyxia in term newborns

Abstract

High-dose phenobarbital or erythropoietin along with supportive treatment has a positive influence on the outcome of newborns with perinatal asphyxia. Phenobarbital has the advantage of low cost and simplicity.

The association between sex-related interleukin-6 gene polymorphisms and the risk for cerebral palsy

“…In addition, the records contain information on maternal factors such as premature rupture of membrane (PROM), pregnancy-induced hypertension (PIH), and threatening premature labor (TPL). Asphyxia was diagnosed using the criteria of the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, and newborns were included when at least three of the four criteria were met [15]. MR was identified based on a score of less than 70 on the Bayley Scales measurement of mental development index [16].…”

Question 1: Phenobarbital for preventing mortality and morbidity in full-term newborns with perinatal asphyxia in a resource-poor setting

“…One of these papers actually found a twofold increase in mortality, however this was non-significant 11. Two papers demonstrated a reduction in mortality rates 10 12. However the second of these had multiple confounders to explain the findings 12…”

“…The final search string (related to low-income countries) was therefore removed and the searches repeated to include studies from all resource levels. These revealed 35, 107 and 377 articles, respectively, of which ten,1–10 six,4 6–8 10 11 and eight1 2 4 6–10 were relevant. Two systematic reviews have previously reviewed this question in 20002 and 2007 1.…”

“…The quality of the individual papers found was however mixed. One meta-analysis1 and three randomised control trials6 9 10 were included, but only one of these used blinding 9. Two of the further papers included used on-call rotas for allocation8 11 while the final study compared two periods of 3 years following the introduction of multiple interventions 12…”

Is phenobarbital a neuroprotective agent in newborn infants with perinatal asphyxia?

“…We read with great interest the article by Avasiloaiei et al that compared the neuroprotective efficacy of high-dose phenobarbital and erythropoietin in term newborns with perinatal asphyxia. 1 Their study included 67 term newborns with perinatal asphyxia who were randomized into three groups: supportive treatment; high-dose phenobarbital; or erythropoietin. In their study, longterm neurologic follow up results were better in the phenobarbital group than the erythropoietin group with respect to motor and cognitive functions at 3 and 6 months, and expressive language skills.…”