Association between maternal serum ionized magnesium levels at delivery and neonatal intraventricular hemorrhage

Mittendorf, Robert; Dambrosia, James M.; Dammann, Olaf; Pryde, Peter G.; Lee, Kwang-Sun; Ben-Ami, Tamar; Yousefzadeh, David K.

doi:10.1067/mpd.2002.123283

Cited by 68 publications

(40 citation statements)

References 39 publications

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“…We have previously reported the significant, unconfounded association between higher levels of maternal serum ionized magnesium circulating at the time of delivery and the subsequent outcome of IVH in babies. 25 Also, when regressing a multivariate model with the postnatal glucocorticoid variable, the association between LSV and IVH remained statistically significant.…”

Section: Resultsmentioning

confidence: 88%

“…13 The question is asked in view of our previous report of an association between serious neurologic injury (Grade III IVH) and pediatric deaths observed in our study 27 as well as our previous report of a significant association between levels of maternal serum ionized magnesium circulating at the time of delivery and the subsequent outcome of neonatal intraventicular hemorrhage. 16 The anticoagulant properties of magnesium have now been reported by several investigators. [28][29][30] In regard to the evolving question of whether neonates who have LSV will become children with neurodevelopmental disabilities (a natural concern given the location (thalamus and basal ganglia) of the LSV lesion), Chamnanvanakij et al 31 have already suggested that such a relationship exists.…”

Section: Discussionmentioning

confidence: 99%

“…Immediately after their collection, blood samples were centrifuged for 10 minutes at 1000 g. Aliquots of pipetted sera were frozen, and then later sent for blinded evaluation of iMg content by the National Institutes of Health, Bethesda, MD, using the AVL 988-4 analyzer (Graz, Austria). Most of the results for this portion of MagNET were reported in the Journal of Pediatrics 16 and Obstetrics and Gynecology. 17 To help determine whether or not congenital infection (as expressed by the fetal inflammatory response syndrome (FIRS) might be present), we evaluated the umbilical cord at delivery for a specific inflammatory cytokine, namely, interleukin-6 (IL-6), as well as histologic funisitis (transmural migration of neutrophils from the vascular lumen through the muscularis of one or more umbilical cord blood vessel walls).…”

Section: Methodsmentioning

confidence: 99%

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Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

et al. 2004

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OBJECTIVES:To determine whether there is an unconfounded association between neonatal intraventricular hemorrhage (IVH) and lenticulostriate vasculopathy (LSV (also known as thalamostriate or mineralizing vasculopathy)). STUDY DESIGN:During the conduct of the Magnesium and Neurologic Endpoints Trial (MagNET), a randomized controlled trial involving maternal, hence fetal, exposure to antenatal magnesium sulfate in the context of preterm labor, head ultrasounds were obtained for each of the surviving neonates. Because of our previous experience in the diagnosis of LSV, when ascertaining the presence of IVH, as called for by the research protocol of our study, the presence or absence of LSV was also determined. RESULTS:We found LSV to be relatively prevalent (10% (14 of 140) among surviving babies). More importantly, it was significantly associated with the occurrence of neonatal IVH, even when controlled for possible confounding (adjusted OR 9.8, 95% confidence interval 1.3 to 73.1; p ¼ 0.03). CONCLUSION:Given the known relationships between IVH and neonatal morbidity and mortality, the finding of a statistically significant association between neonatal IVH and LSV may suggest more substantial implications for the latter than previously believed.

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Section: Resultsmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

et al. 2004

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“…The importance of the cumulative total dose of MgSO 4 administered to the mother has been suggested elsewhere in the literature. 8,15 In randomized trials reporting no excess of perinatal mortality the dose of MgSO 4 was not computed. Some of the clinical trials of MgSO 4 used much lower cumulative dosages and so they do not answer the question as to whether high magnesium doses contribute to perinatal morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Infants who had intraventricular hemorrhage (IVH) were more likely to have been delivered to mothers with higher serum ionized magnesium levels. 8 These data suggest that there is a therapeutic window requiring dose limitations above which toxicity may increase. 9 Magnesium plays an important role in the regulation of vascular tone.…”

Section: Introductionmentioning

confidence: 99%

Antenatal exposure to magnesium sulfate and the incidence of patent ductus arteriosus in extremely low birth weight infants

et al. 2007

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Objective: Magnesium sulfate (MgSO 4 ) is the most commonly used tocolytic agent in the US and is also employed as a prophylactic agent against seizures in pre-eclamptic women. MgSO 4 crosses the placenta and its concentration in the newborn usually exceeds that of maternal levels. The purpose of this study was to explore the relationship between antenatal exposure to MgSO 4 and the incidence of patent ductus arteriosus (PDA) in extremely low birth weight infants.Study design: A total of 954 neonates with birth weights between 500 and 1000 g, born at the University of Miami/Jackson Memorial Hospital between January 1995 and December 2004 and surviving for more than 3 days, were followed until death or discharge from the hospital. The incidence of PDA in infants exposed to MgSO 4 was compared with those not exposed and comparisons were also made between infants exposed to different maternal doses of MgSO 4 .Results: The incidence of PDA was significantly higher in the group of infants exposed to MgSO 4 compared with the unexposed control group (67 vs. 60%, P<0.018). When stratified by gestational age the differences were significant only in the group of infants with a gestational age of X26 weeks (58 vs. 49%, P<0.039). Logistic regression analysis to adjust for co-variables indicated an increased risk of PDA with higher doses of MgSO 4 (odds ratio 1.33 confidence interval (CI) 1.12 to 1.58, per 50 g of MgSO 4 ). Conclusion:Antenatal exposure to MgSO 4 is associated with a higher risk of PDA in extremely low birth weight infants and this effect is more significant and dose-related in more mature infants.

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Magnesium sulphate for preventing preterm birth in threatened preterm labour

Crowther

Hiller

Doyle

2002

Cochrane Database of Systematic Reviews

186

100

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Association between maternal serum ionized magnesium levels at delivery and neonatal intraventricular hemorrhage

Cited by 68 publications

References 39 publications

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

Antenatal exposure to magnesium sulfate and the incidence of patent ductus arteriosus in extremely low birth weight infants

Magnesium sulphate for preventing preterm birth in threatened preterm labour

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