The effect of maternal ketanserin use on the circulation of the neonate: a prospective, observational study

Abstract Objective High ketanserin levels are found in the umbilical cord after maternal treatment. However, the effect on the circulation of the neonate has never been investigated. Study design A prospective, observational study was performed at the neonate ward at the Medical Centre Leeuwarden, The Netherlands. All neonates exposed in utero to ketanserin administered to the mother, from May 2007 to December 2009 ( n  = 58), were included. We studied the effect of ketanserin exposure on the circulation of the neonate, by monitoring heart rate and blood pressure during the first 24 h of life. Non-parametric as well as parametric tests were used to analyze the effect of gestational age, birth weight, gender, various ketanserin factors (cumulative dosage, duration of therapy and last dosage rate), other maternal drug use and maternal diagnosis on the blood pressure of the neonate. Results Eight neonates became hypotensive during the first 8 h of life (13.8%). The last dosage rate as well as the mean dosage rate (cumulative dosage divided by duration of therapy in hours) were significantly higher in the group with hypotension ( P  = .005 and P  = .002, respectively). All hypotensive neonates were exposed to a last dosage rate of at least 8 mg/h. Maternal HELLP syndrome was diagnosed more often in hypotensive compared to normotensive neonates ( P  = .048). Conclusion In utero exposure to ketanserin lowers the blood pressure of the neonate. The risk of hypotension is associated with the last dosage rate of maternal ketanserin treatment and the co-existence of maternal HELLP syndrome.