Tocolysis with the β-2-sympathomimetic hexoprenaline increases occurrence of infantile haemangioma in preterm infants

Arch Dis Child Fetal Neonatal Ed. 2013 Mar;98(2):F108-11. doi: 10.1136/archdischild-2011-301030. Epub 2012 May 18.

Abstract

Background: Infantile haemangioma (IH) is the most commonly observed tumour in children. Off-label pharmacological treatment of IH with the beta-blocker propranolol induces regression of IH. Based on the fact that IH are more frequently observed in premature babies than in mature babies and the evidence that beta-blocker therapy leads to regression of IH, the authors generated the hypothesis that the use of β-2-sympathomimetics during pregnancy for inhibiting premature labour might increase occurrence of IH in preterm infants.

Methods: For group comparison t test, Mann-Whitney U test and Fisher's exact test were used. Logistic regression was carried out by the forward stepwise method with Wald statistics.

Results: Data of 328 preterm infants (<32 gestational weeks) or with a birth weight of less than 1500 g (<36 gestational weeks) born between January 2006 and December 2008 were analysed. A total of 15 were excluded due do death within the 1st month of life, 38 because of lost to follow-up and six due to incomplete data. Complete data of 269 preterm infants were retrospectively analysed. During the follow-up period of median 1.6 years, 50 infants developed one or more IH within their first 6 months of life. IH occurred in 40/181 patients with intrauterine exposure to the β-2-sympathomimetic hexoprenaline and in 10/88 without exposure (OR=4.3; 95% CI 1.4 to 13.8). Furthermore, the influence of antenatal exposure to glucocorticosteroids for induction of lung development was analysed. Prenatally exposed subjects showed reduced occurrence of IH (OR=0.2; 95% CI 0.05 to 0.8).

Conclusion: Intrauterine exposure to the β-2-sympathomimetic hexoprenaline might increase the occurrence of IH in preterm infants.

MeSH terms

  • Adrenergic beta-2 Receptor Agonists / adverse effects*
  • Adrenergic beta-2 Receptor Agonists / therapeutic use
  • Female
  • Glucocorticoids / therapeutic use
  • Hemangioma / chemically induced*
  • Hemangioma / prevention & control
  • Hexoprenaline / adverse effects*
  • Hexoprenaline / therapeutic use
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / chemically induced*
  • Infant, Premature, Diseases / prevention & control
  • Male
  • Maternal-Fetal Exchange
  • Obstetric Labor, Premature / prevention & control
  • Pregnancy
  • Prenatal Exposure Delayed Effects / chemically induced
  • Retrospective Studies
  • Tocolysis / adverse effects
  • Tocolytic Agents / adverse effects*
  • Tocolytic Agents / therapeutic use

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Glucocorticoids
  • Tocolytic Agents
  • Hexoprenaline