{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:20:26Z","timestamp":1788916826468,"version":"build-2803163510"},"reference-count":38,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,7,1]]},"abstract":"<jats:p>BACKGROUND: Fetal hypoxia is an important determinant of neonatal encephalopathy caused by birth asphyxia, in which hypoxia-induced free radical formation plays an important role.<\/jats:p>\n               <jats:p>HYPOTHESIS: Maternal treatment with allopurinol, will cross the placenta during fetal hypoxia (primary outcome) and reduce S-100B and free radical formation (secondary outcome).<\/jats:p>\n               <jats:p>METHODS: In a randomized, double-blind feasibility study, 53 pregnant women in labor (54 fetuses) with a gestational age of &amp;gt;36 weeks and fetal hypoxia, as indicated by abnormal\/nonreassuring fetal heart rate tracing or fetal scalp pH of &amp;lt;7.20, received 500 mg of allopurinol or placebo intravenously. Severity of fetal hypoxia, brain damage and free radical formation were assessed by arterial cord blood lactate, S-100B and non-protein-bound-iron concentrations, respectively. At birth, maternal and cord blood concentrations of allopurinol and its active metabolite oxypurinol were determined.<\/jats:p>\n               <jats:p>RESULTS: Allopurinol and oxypurinol concentrations were within the therapeutic range in the mother (allopurinol &amp;gt; 2 mg\/L and\/or oxypurinol &amp;gt; 4 mg\/L) but not always in arterial cord blood. We therefore created 3 groups: a placebo (n = 27), therapeutic allopurinol (n = 15), and subtherapeutic allopurinol group (n = 12). Cord lactate concentration did not differ, but S-100B was significantly lower in the therapeutic allopurinol group compared with the placebo and subtherapeutic allopurinol groups (P &amp;lt; .01). Fewer therapeutic allopurinol cord samples had measurable non\u2013protein-bound iron concentrations compared with placebo (P &amp;lt; .01).<\/jats:p>\n               <jats:p>CONCLUSIONS: Maternal allopurinol\/oxypurinol crosses the placenta during fetal hypoxia. In fetuses\/newborns with therapeutic allopurinol\/oxypurinol concentrations in cord blood, lower plasma levels of the brain injury marker protein S-100B were detected. A larger allopurinol trial in compromised fetuses at term seems warranted. The allopurinol dosage must be adjusted to achieve therapeutic fetal allopurinol\/oxypurinol concentrations.<\/jats:p>","DOI":"10.1542\/peds.2008-2228","type":"journal-article","created":{"date-parts":[[2009,6,29]],"date-time":"2009-06-29T15:18:44Z","timestamp":1246288724000},"page":"350-357","source":"Crossref","is-referenced-by-count":69,"title":["Maternal Allopurinol During Fetal Hypoxia Lowers Cord Blood Levels of the Brain Injury Marker S-100B"],"prefix":"10.1542","volume":"124","author":[{"given":"Helen L.","family":"Torrance","sequence":"first","affiliation":[{"name":"Perinatal Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon J.","family":"Benders","sequence":"additional","affiliation":[{"name":"Perinatal Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan B.","family":"Derks","sequence":"additional","affiliation":[{"name":"Perinatal Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carin M. A.","family":"Rademaker","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University Medical Center\/Wilhelmina Children's Hospital, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie F.","family":"Bos","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics and Neonatology, University Medical Center, Groningen, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Van Den Berg","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics and Neonatology, University Medical Center, Groningen, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Longini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Pediatrics, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Buonocore","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Pediatrics, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MariaElena","family":"Venegas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Universidad Del Norte, Barranquilla, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hernando","family":"Baquero","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Universidad Del Norte, Barranquilla, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard H. 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