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Antenatal exposure to fenoterol is not associated with the development of retinopathy of prematurity in infants born before 32 weeks of gestation

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Despite safety concerns, β2-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 β2-sympathomimetic fenoterol contributes to the development of ROP.

Methods

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.

Results

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.

Conclusion

β2-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.

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Funding

No external or internal funding was received for this project.

Author information

Authors and Affiliations

  1. Department of Neonatology, Heidelberg University Hospital, Heidelberg, Germany

    Hannes Hudalla & Johannes Pöschl

  2. Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany

    Thomas Bruckner

  3. Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg University Hospital, Heidelberg, Germany

    Thomas Strowitzki & Ruben-J. Kuon

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  1. Hannes Hudalla
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  5. Ruben-J. Kuon
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Contributions

HH: protocol/project development, data collection or management, data analysis, and manuscript writing/editing. TB: data collection or management and data analysis. JP: manuscript editing. TS: manuscript editing. RJK: protocol/project development, data collection or management, data analysis, and manuscript writing/editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ruben-J. Kuon.

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All authors declare no conflict of interest.

Ethical approval

The study was approved by the Heidelberg University institutional Review Board (IRB, S-094/2013). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The institutional ethics committee waived informed consent due to the retrospective nature of the study, and pseudonymization of data.

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Hudalla, H., Bruckner, T., Pöschl, J. et al. Antenatal exposure to fenoterol is not associated with the development of retinopathy of prematurity in infants born before 32 weeks of gestation. Arch Gynecol Obstet 301, 687–692 (2020). https://doi.org/10.1007/s00404-020-05463-z

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