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Early postnatal allopurinol does not improve short term outcome after severe birth asphyxia

¹ Department of Neonatology, Wilhelmina Children’s Hospital/University Medical Center, Utrecht, the Netherlands
² Department of Pharmacy, Wilhelmina Children’s Hospital/University Medical Center, Utrecht
³ Department of Neonatology, University Medical Center, Groningen, the Netherlands
⁴ Department of Neonatology, Leiden University Medical Center, the Netherlands

Correspondence to:
Correspondence to:
Dr Benders
Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center KE 4.123.1, PO Box 85090, 3508 AB Utrecht, the Netherlands; m.benders{at}azu.nl

Objective: To investigate whether postnatal allopurinol would reduce free radical induced reperfusion/reoxygenation injury of the brain in severely asphyxiated neonates.

Method: In an interim analysis of a randomised, double blind, placebo controlled study, 32 severely asphyxiated infants were given allopurinol or a vehicle within four hours of birth.

Results: The analysis showed an unaltered (high) mortality and morbidity in the infants treated with allopurinol.

Conclusion: Allopurinol treatment started postnatally was too late to reduce the early reperfusion induced free radical surge. Allopurinol administration to the fetus with (imminent) hypoxia via the mother during labour may be more effective in reducing free radical induced post-asphyxial brain damage.

Abbreviations: aEEG, amplitude integrated electroencephalogram; MRI, magnetic resonance imaging

Keywords: allopurinol; neuroprotection; reperfusion injury; birth asphyxia

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