Lack of Evidence for Time or Dose Relationship between Antenatal Magnesium Sulfate and Intestinal Injury in Extremely Preterm Neonates.

Neonatology 2019 9;115(4):371-378. Epub 2019 Apr 9.

Division of Neonatology, Pomona Valley Hospital Medical Center, Pomona, California, USA.

Background: Recent studies reported conflicting results on the relationship between antenatal magnesium sulfate (MgSO4) exposure and neonatal intestinal injury. Most studies have not assessed MgSO4 exposure quantitatively and none reported the exposure timing.

Objectives: The aim of this work was to assess whether there is a temporal or dose-dependent relationship between antenatal MgSO4 exposure and intestinal injury in extremely preterm neonates.

Methods: A retrospective study was made of inborn neonates with gestational age ≤28 weeks and/or birth weights ≤1,000 g. Primary outcomes included necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), and/or death prior to discharge or in the first 2 weeks of life. Outcome comparisons were made based on the timing of MgSO4 exposure, within 7 days (Mg7D) or within 3 days (Mg3D) of birth. Total cumulative doses for the Mg3D group were also computed.

Results: A total of 302 neonates were included, 210 in the Mg7D group, out of whom 179 (85.2%) constituted the Mg3D group. There were no differences noted when comparing MgSO4 exposure timing and the likelihood of NEC, SIP, and/or death. This remained the same for subgroup analysis of neonates < 26 weeks' gestation. Each 10-g increase in MgSO4 cumulative dose correlated with a decrease in SIP/NEC/death by 18.9% prior to discharge and by 21.9% in the first 2 weeks of life. Small for gestational age (SGA) was a potential effect modifier by a likelihood ratio test with p = 0.07.

Conclusions: Antenatal MgSO4 exposure in extremely preterm neonates was not associated with an increased risk of intestinal injury or death, and might have reduced these complications in a dose-dependent manner in our study. This protective effect was more noticeable in SGA neonates.

Download full-text PDF

Source
http://dx.doi.org/10.1159/000497412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6554036PMC
December 2019

Publication Analysis

Top Keywords

mgso4 exposure
24
intestinal injury
16
relationship antenatal
12
extremely preterm
12
weeks life
8
antenatal magnesium
8
injury extremely
8
preterm neonates
8
mg3d group
8
magnesium sulfate
8
gestational age
8
antenatal mgso4
8
sip and/or
8
and/or death
8
prior discharge
8
exposure
7
mgso4
7
neonates
6
intestinal
5
included 210
4

Similar Publications