Effect of prophylactic phenobarbital on seizures, encephalopathy and mortality in neonates with perinatal asphyxia

  • S Velaphi
  • M Mokhachane
  • R Mphahlele
  • E Beckh-Arnold


Background. Seizures after an asphyxial insult may result in brain damage in neonates. Prophylactic phenobarbital may reduce seizures.
Objective. To determine the e€ect of prophylactic phenobarbital on seizures, death and neurological outcome at hospital discharge.
Methods. Neonates with base de.cit >16 mmol/l and Apgar score at 5 minutes <7 or requiring resuscitation for >5 minutes at the time of
birth were randomised to prophylactic phenobarbital 40 mg/kg (n=50) or placebo (controls) (n=44) within the .rst 6 hours of life. .ey were
monitored for clinical seizures, hypoxic ischaemic encephalopathy (HIE) and mortality.
Results. Seizures developed in 30.0% of the phenobarbital group as opposed to 47.7% of the control group (relative risk 0.63; 95% con.dence
interval -0.37 - 1.06; p=0.083). .e proportions of patients who had died and/or had HIE II or III at time of discharge from hospital were
similar in the two groups (42.0% v. 45.5%). .ere were no di€erences in mortality between the two groups (14.0% v. 15.9%).
Conclusion. In infants with asphyxia, prophylactic phenobarbital does not reduce the incidence of seizures, HIE and mortality.

Journal Identifiers

eISSN: 1999-7671
print ISSN: 1994-3032