Effect of metoclopramide administration to mothers on neonatal bilirubin and maternal prolactin: a randomized, controlle
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ORIGINAL ARTICLE
Effect of metoclopramide administration to mothers on neonatal bilirubin and maternal prolactin: a randomized, controlled, clinical trial Shirin Osouli Tabrizi1 · Mojgan Mirghafourvand2 · Abdollah Jannat Dost3 · Sakineh Mohammad‑Alizadeh‑Charandabi4 · Yousef Javadzadeh5 · Robabe Seyedi1 Received: 12 July 2018 / Accepted: 22 November 2018 © Children’s Hospital, Zhejiang University School of Medicine 2018
Abstract Background Jaundice is a common neonatal problem. This study was conducted to determine the effect of metoclopramide on neonatal bilirubin and maternal prolactin (primary outcomes) and milk volume (secondary outcome). Methods This triple-blind, randomized, controlled, clinical trial was conducted on 112 mothers. The participants were assigned to the intervention (metoclopramide) and control groups (placebo) using block randomization. Ten-mg metoclopramide and placebo tablets were taken by the participants three times a day. The intervention began in the first 2–10 hours after childbirth and continued until the fifth day. The mothers’ prolactin level was measured on the first morning after the intervention and on the sixth day (1 day after the intervention was over). Neonatal total bilirubin was also measured before the intervention and on the sixth day. Results After the intervention, the two groups did not differ significantly in terms of the mean neonatal indirect bilirubin (P = 0.565) and milk volume (P = 0.261), but the mean serum prolactin was significantly higher in the metoclopramide group compared to the placebo group (adjusted mean difference 37; 95% confidence interval 58.1–16.5; P = 0.001). Conclusions Metoclopramide increased maternal serum prolactin but had no effects on neonatal jaundice. The insufficient numbers of studies on this subject mandate further research. Keywords Bilirubin · Metoclopramide · Milk volume · Neonate · Prolactin
Introduction
* Mojgan Mirghafourvand [email protected] 1
Department of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
2
Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
3
Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
4
Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
5
Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
Jaundice is a common neonatal problem [1]. Bilirubin is predominantly produced following hemoglobin breakdown in the red blood cells or its hemolysis, which lead to the production of heme. Heme is catabolized by heme-oxygenase into biliverdin. The excess biliverdin is converted into bilirubin by biliverdin reductase. Bilirubin then enters the liver and turns into direct bilirubin, and then enters the intestinal lumen, where it can convert back into indirect bilirubin and enter the blood flow. When there is a balance between its production and elimination, the
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