Magnesium Sulfate Use in Pregnancy for Preeclampsia Prophylaxis and Fetal Neuroprotection

Brookfield, Kathleen; Mbata, Osinakachukwu

doi:10.1016/j.ogc.2022.10.003

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…Notably, we observed null difference of Mg status between CP and controls, which may be due to that Mg was not directly associated with the neurodevelopment. Notably, Mg sulfate was commonly applied in obstetrics due to its prevention effect of eclamptic seizures 50 , which may also affect the Mg status in neonates. Further larger numbers of studies are needed to validate our findings.…”

Section: Discussionmentioning

confidence: 99%

Association between Cu/Zn/Iron/Ca/Mg levels and cerebral palsy: a pooled-analysis

Zhu,

Mao,

2023

Sci Rep

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It was well documented that macro/trace elements were associated with the neurodevelopment. We aimed to investigate the relationship between copper (Cu)/zinc (Zn)/iron/calcium (Ca)/magnesium (Mg) levels and cerebral palsy (CP) by performing a meta-analysis. We searched the PubMed, Embase, Cochrane and Chinese WanFang databases from January 1985 to June 2022 to yield studies that met our predefined criteria. Standard mean differences (SMDs) of Cu/Zn/Iron/Ca/Mg levels between CP cases and healthy controls were calculated using the fixed-effects model or the random-effects model, in the presence of heterogeneity. 95% confidence intervals (CI) were also computed. Sensitivity analysis was performed by omitting each study in turn. A total of 19 studies were involved in our investigation. CP cases showed markedly lower Cu, Zn, iron and Ca levels than those in controls among overall populations (SMD = − 2.156, 95% CI − 3.013 to − 1.299, P < 10−4; SMD = − 2.223, 95% CI − 2.966 to − 1.480, P < 10−4; SMD = − 1.092, 95% CI − 1.513 to − 0.672, P < 10−4; SMD = − 0.757, 95% CI − 1.475 to − 0.040, P = 0.038) and Asians (SMD = − 2.893, 95% CI − 3.977 to − 1.809, P < 10−4; SMD = − 2.559, 95% CI − 3.436 to − 1.683, P < 10−4; SMD = − 1.336, 95% CI − 1.807 to − 0.865, P < 10−4; SMD = − 1.000, 95% CI − 1.950 to − 0.051, P = 0.039). CP cases showed markedly lower Zn level than that in controls among Caucasians (SMD = − 0.462, 95% CI − 0.650 to − 0.274, P < 10−4). No significant differences of Cu, iron and Ca levels between CP cases and controls among Caucasians (SMD = − 0.188, 95% CI − 0.412 to 0.037, P = 0.101; SMD = − 0.004, 95% CI − 0.190 to 0.182, P = 0.968; SMD = 0.070, 95% CI − 0.116 to 0.257, P = 0.459) were observed. No marked difference of Mg level between CP cases and controls was noted among overall populations (SMD = − 0.139, 95% CI − 0.504 to 0.226, P = 0.455), Asians (SMD = − 0.131, 95% CI − 0.663 to 0.401, P = 0.629), and Caucasians (SMD = − 0.074, 95% CI − 0.361 to 0.213, P = 0.614). Sensitivity analysis did not change the overall results significantly for Cu, Zn, iron and Mg. CP cases demonstrated significantly lower levels of Cu/Zn/iron/Ca than those in healthy controls, particularly in Asians. Decreasing trend of Cu/Zn/iron/Ca levels merit attention, particularly in the population with high susceptibility to CP. Frequent monitoring and early intervention may be needed.

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Section: Discussionmentioning

confidence: 99%

Association between Cu/Zn/Iron/Ca/Mg levels and cerebral palsy: a pooled-analysis

Zhu,

Mao,

2023

Sci Rep

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“…An infusion of MgSO4 has been shown to lessen postoperative pain. One study assessed the impact of MgSO4 administered before surgery on obstetric patients' postoperative discomfort [ 55 , 56 ]. They found that giving patients an intravenous MgSO4 bolus before putting them under general anesthesia can lessen the impact of morphine consumption on postoperative VAS scores and the first 24 hours after surgery.…”

Section: Reviewmentioning

confidence: 99%

Magnesium Sulfate and Its Versatility in Anesthesia: A Comprehensive Review

Dahake,

Verma,

Bawiskar

2024

Cureus

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In the field of general anesthesia, magnesium sulfate (MgSO4) has become a valuable adjunct because it provides a range of benefits that enhance and optimize conventional aesthetic procedures. This review highlights the various intra-anesthetic benefits of MgSO4 while examining its complex function in the treatment using anesthesia. Magnesium inhibits the release of acetylcholine at the motor endplate and blocks calcium channels at presynaptic nerve terminals. This reduces the amplitude of endplate potential and the excitability of muscle fibers, which increases the potency of a neuromuscular blockade by nondepolarizing neuromuscular blockers. This activity may lessen the need for primary muscle relaxants. Moreover, its capacity to potentially reduce the total amount of main aesthetic agents needed emphasizes its function in maximizing anesthesia dosage, ensuring sufficient depth while perhaps potentially reducing adverse effects linked with increased dosages. MgSO4’s adaptable qualities present a viable path for improving anesthetic outcomes, possibly improving patient safety and improving surgical results.

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“…This drug can be considered one of the most frequently prescribed medications in obstetrics for eclampsia and fetal neuroprotection ( Brookfield and Mbata, 2023 ). Although not a typical anticonvulsant, MgSO₄ is the first-line treatment for eclampsia seizure and prophylaxis of eclampsia seizure recurrence ( Laskowska, 2023 ).…”

Section: Magnesium Sulfatementioning

confidence: 99%

Emerging therapeutic strategies in hypoxic-ischemic encephalopathy: a focus on cognitive outcomes

Marques,

Rodrigues,

Balduci

et al. 2024

Front. Pharmacol.

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Perinatal hypoxia-ischemia represents a significant risk to CNS development, leading to high mortality rates, diverse damages, and persistent neurological deficits. Despite advances in neonatal medicine in recent decades, the incidence of HIE remains substantial. Motor deficits can manifest early, while cognitive impairments may be diagnosed later, emphasizing the need for extended follow-up. This review aims to explore potential candidates for therapeutic interventions for hypoxic-ischemic encephalopathy (HIE), with a focus on cognitive deficits. We searched randomized clinical trials (RCT) that tested drug treatments for HIE and evaluated cognitive outcomes. The results included studies on erythropoietin, melatonin, magnesium sulfate, topiramate, and a combination of vitamin C and ibuprofen. Although there are several indications of the efficacy of these drugs among animal models, considering neuroprotective properties, the RCTs failed to provide complete effectiveness in the context of cognitive impairments derived from HIE. More robust RCTs are still needed to advance our knowledge and to establish standardized treatments for HIE.

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Magnesium Sulfate Use in Pregnancy for Preeclampsia Prophylaxis and Fetal Neuroprotection

Cited by 8 publications

References 31 publications

Association between Cu/Zn/Iron/Ca/Mg levels and cerebral palsy: a pooled-analysis

Association between Cu/Zn/Iron/Ca/Mg levels and cerebral palsy: a pooled-analysis

Magnesium Sulfate and Its Versatility in Anesthesia: A Comprehensive Review

Emerging therapeutic strategies in hypoxic-ischemic encephalopathy: a focus on cognitive outcomes

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