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.