Pentaerythrityltetranitrate improves the outcome of children born to mothers with compromised uterine perfusion - 12 months follow-up and safety data of the double blinded randomized PETN-trial.

fetal growth restriction follow up at the age of 12 months pentaerythritol tetranitrate placental insufficiency placental perfusion preterm birth

Journal

American journal of obstetrics & gynecology MFM
ISSN: 2589-9333
Titre abrégé: Am J Obstet Gynecol MFM
Pays: United States
ID NLM: 101746609

Informations de publication

Date de publication:
07 Mar 2024
Historique:
received: 10 11 2023
revised: 06 02 2024
accepted: 27 02 2024
medline: 10 3 2024
pubmed: 10 3 2024
entrez: 9 3 2024
Statut: aheadofprint

Résumé

This is a follow up study to the PETN randomized controlled multicenter trial that reports neonatal outcome data of newborns admitted to neonatal intensive care units (NICU) and outcome data of the offspring at 12 months of age. The PETN-trial was a randomized, double blind, placebo-controlled study designed to assess the efficacy and safety of the NO-donor pentaerytrithyltetranitrate (PETN) in the prevention of fetal growth restriction (FGR) and perinatal death in pregnancies complicated by abnormal placental perfusion. We present data on adverse events (AE) reported during the study to document the safety of PETN-treatment during pregnancy. To further evaluate the effects of PETN on neonatal and long-term outcomes we present data from 144 newborns admitted to NICU during the trial and follow up data of 240 children at 12 months of age, including information on height, weight, head circumference, developmental milestones and the presence of chronic disease. Results at 12 months demonstrated that significantly more children were age appropriately developed without impairments in the PETN group (p = 0.018). Additionally, the presence of chronic disease was lower in the PETN group (p= 0.041). Outcome data of the 144 newborns admitted to the NICU did not reveal differences between the treatment and placebo groups. There were no differences in number or nature of reported AEs between the study groups. The analysis shows that study children born in the PETN cohort have a clear advantage compared to the Placebo group at the age of 12 months, as evidenced by the increased incidence of normal development without the presence of chronic disease. Although safety has been proven, further follow up studies are necessary to justify PETN treatment during pregnancies complicated by impaired uterine perfusion.

Sections du résumé

BACKGROUND BACKGROUND
This is a follow up study to the PETN randomized controlled multicenter trial that reports neonatal outcome data of newborns admitted to neonatal intensive care units (NICU) and outcome data of the offspring at 12 months of age.
OBJECTIVE AND STUDY DESIGN OBJECTIVE
The PETN-trial was a randomized, double blind, placebo-controlled study designed to assess the efficacy and safety of the NO-donor pentaerytrithyltetranitrate (PETN) in the prevention of fetal growth restriction (FGR) and perinatal death in pregnancies complicated by abnormal placental perfusion. We present data on adverse events (AE) reported during the study to document the safety of PETN-treatment during pregnancy. To further evaluate the effects of PETN on neonatal and long-term outcomes we present data from 144 newborns admitted to NICU during the trial and follow up data of 240 children at 12 months of age, including information on height, weight, head circumference, developmental milestones and the presence of chronic disease.
RESULTS RESULTS
Results at 12 months demonstrated that significantly more children were age appropriately developed without impairments in the PETN group (p = 0.018). Additionally, the presence of chronic disease was lower in the PETN group (p= 0.041). Outcome data of the 144 newborns admitted to the NICU did not reveal differences between the treatment and placebo groups. There were no differences in number or nature of reported AEs between the study groups.
CONCLUSION CONCLUSIONS
The analysis shows that study children born in the PETN cohort have a clear advantage compared to the Placebo group at the age of 12 months, as evidenced by the increased incidence of normal development without the presence of chronic disease. Although safety has been proven, further follow up studies are necessary to justify PETN treatment during pregnancies complicated by impaired uterine perfusion.

Identifiants

pubmed: 38460823
pii: S2589-9333(24)00058-2
doi: 10.1016/j.ajogmf.2024.101332
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101332

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors report no conflict of interest

Auteurs

Tanja Groten (T)

Department of Obstetrics, Jena University Hospital, Jena, Germany. Electronic address: tanja.groten@med.uni-jena.de.

Thomas Lehmann (T)

Institute of Medical Statistics and Computer Science, Jena University Hospital, Jena, Germany; Center for Clinical Studies, Jena University Hospital, Jena, Germany.

Mariann Städtler (M)

Center for Clinical Studies, Jena University Hospital, Jena, Germany.

Matej Komar (M)

Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany.

Jennifer Lucia Winkler (JL)

Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany.

Mateja Condic (M)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany.

Brigitte Strizek (B)

Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany.

Sven Seeger (S)

Department of Gynaecology and Obstetrics, Perinatal Centre, St. Elisabeth and St. Barbara Halle, Halle (Saale), Germany.

Yvonne Jäger (Y)

Department of Obstetrics, Christian-Albrechts-University of Kiel, Kiel, Germany.

Ulrich Pecks (U)

Department of Obstetrics and Gynaecology, Department of Maternal Health and Midwifery, University Medical Centre Würzburg, Würzburg, Germany.

Christel Eckmann-Scholz (C)

Department of Obstetrics, Christian-Albrechts-University of Kiel, Kiel, Germany.

Karl Oliver Kagan (KO)

Department of Feto-Maternal Medicine, Women's University Hospital Tübingen, Tübingen, Germany.

Markus Hoopmann (M)

Department of Feto-Maternal Medicine, Women's University Hospital Tübingen, Tübingen, Germany.

Constantin S von Kaisenberg (CS)

Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany.

Bettina Hertel (B)

Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany.

Anne Tauscher (A)

Department of Obstetrics and Gynecology, University of Leipzig, Leipzig, Germany.

Susanne Schrey-Petersen (S)

Department of Obstetrics and Gynecology, University of Leipzig, Leipzig, Germany.

Ulrike Friebe-Hoffmann (U)

Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany.

Krisztian Lato (K)

Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany.

Christoph Hübener (C)

Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, LMU Munich, Munich, Germany.

Maria Delius (M)

Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, LMU Munich, Munich, Germany.

Stefan Verlohren (S)

Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Dorota Sroka (D)

Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Dietmar Schlembach (D)

Vivantes Network of Health GmbH, Clinicum Neukoelln, Clinic for Obstetric Medicine, Berlin, Germany.

Laura de Vries (L)

Department of Obstetrics and Gynecology Städtisches Klinikum Harlaching Munich, Germany.

Katrina Kraft (K)

Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Lübeck, Germany.

Gregor Seliger (G)

Center for Reproductive Medicine and Andrology, University Medical Center Halle (Saale), Halle (Saale), Germany.

Ekkehard Schleußner (E)

Department of Obstetrics, Jena University Hospital, Jena, Germany.

Classifications MeSH