Protection of brain development by antenatal magnesium sulphate for infants born preterm

Chollat, Clément; Sentilhes, Loïc; Marret, Stéphane

doi:10.1111/dmcn.14038

Cited by 22 publications

(12 citation statements)

References 39 publications

(76 reference statements)

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“…MgSO 4 administration was a protective factor for neonatal hypoglycemia in univariate analysis, but became non-significant in multivariate analysis. Antenatal MgSO 4 reduces incidence of cerebral palsy and hemorrhage in infants born preterm, regardless of total dose (19)(20)(21). MgSO 4 has been shown to decrease blood brain barrier permeability and increase plasma glucose concentration in a rat model of hypoglycemia (22).…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Hypoglycemia During Fetal-to-Neonatal Transition in Premature Infants

et al. 2020

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Objective: To determine the incidence and risk factors associated with neonatal hypoglycemia in the premature population <33 weeks' gestation.Methods: This was a secondary retrospective analysis from previous infants enrolled in randomized controlled trials. A total of 255 infants <33 weeks' gestation were born during the study period. Eight infants were excluded due to missing glucose or maternal data and 175 infants were analyzed.Main outcome measures: Primary outcome was hypoglycemia (blood glucose <2.6mmol/L) determined via glucose oxidase method on arterial or venous blood gas. Birth weight subgroups: small for gestational age (SGA, birth weight <10%ile for gestational age) and large for gestational age (LGA, birth weight >90%ile for gestational age). Maternal hypertension was systolic blood pressure >140mmHg.Results: 175 infants <33 weeks' gestational age (89 male, 84 female) were analyzed. Hypoglycemia occurred in 59 infants (33.7%). Maternal hypertension (OR 3.07, 95% CI 1.51-6.30, p = 0.002) was the sole risk factor for neonatal hypoglycemia. Protective factors for hypoglycemia included labor at time of delivery (OR 4.51, 95% CI 2.29-9.18, p <0.0001) and antenatal magnesium sulfate (OR 2.53, 95% CI 1.23-5.50, p = 0.01). There were no significant differences between hypoglycemic and euglycemic infants in sex, gestational age, LGA infants, antenatal steroids, vaginal birth, or maternal diabetes. SGA infants were excluded from analysis due to sample size. Conclusions:Premature infants <33 weeks' gestation have increased risk of hypoglycemia. Maternal hypertension increases hypoglycemia risk. Antenatal magnesium sulfate administration or labor at time of delivery decrease hypoglycemia risk.

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Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Hypoglycemia During Fetal-to-Neonatal Transition in Premature Infants

et al. 2020

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“…Magnesium appears to be a potent tool for the prevention of cerebral palsy and resulting disabilities when administered as MgSO 4 to women in danger of preterm delivery before 33 completed weeks of gestation (GWs) [1][2][3][4]. Historically, MgSO 4 used as a tocolytic did not prove to have efficiency in retarding delivery, but retrospectively it has shown neuroprotection effects at low doses [5,6].…”

Section: Introductionmentioning

confidence: 99%

Effect of Neuroprotective Magnesium Sulfate Treatment on Brain Transcription Response to Hypoxia Ischemia in Neonate Mice

Dieu-Lugon

Dupré

Derambure

et al. 2021

IJMS

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MgSO4 is widely used in the prevention of preterm neurological disabilities but its modes of action remain poorly established. We used a co-hybridization approach using the transcriptome in 5-day old mice treated with a single dose of MgSO4 (600 mg/kg), and/or exposed to hypoxia-ischemia (HI). The transcription of hundreds of genes was altered in all the groups. MgSO4 mainly produced repressions culminating 6 h after injection. Bio-statistical analysis revealed the repression of synaptogenesis and axonal development. The putative targets of MgSO4 were Mnk1 and Frm1. A behavioral study of adults did not detect lasting effects of neonatal MgSO4 and precluded NMDA-receptor-mediated side effects. The effects of MgSO4 plus HI exceeded the sum of the effects of separate treatments. MgSO4 prior to HI reduced inflammation and the innate immune response probably as a result of cytokine inhibition (Ccl2, Ifng, interleukins). Conversely, MgSO4 had little effect on HI-induced transcription by RNA-polymerase II. De novo MgSO4-HI affected mitochondrial function through the repression of genes of oxidative phosphorylation and many NAD-dehydrogenases. It also likely reduced protein translation by the repression of many ribosomal proteins, essentially located in synapses. All these effects appeared under the putative regulatory MgSO4 induction of the mTORC2 Rictor coding gene. Lasting effects through Sirt1 and Frm1 could account for this epigenetic footprint.

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“…To our knowledge, there is currently no method available for predicting those at greatest risk of developing the disease. Moreover, only two strategies have succeeded in decreasing CP in 2-year-old children, which include the use of hypothermia in full-term newborns with moderate neonatal encephalopathy [19,20] and the administration of magnesium sulfate to mothers in preterm labor [21,22].…”

Section: Introductionmentioning

confidence: 99%

Metabolomic Profiling of Cerebral Palsy Brain Tissue Reveals Novel Central Biomarkers and Biochemical Pathways Associated with the Disease: A Pilot Study

et al. 2019

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Cerebral palsy (CP) is one of the most common causes of motor disability in childhood, with complex and heterogeneous etiopathophysiology and clinical presentation. Understanding the metabolic processes associated with the disease may aid in the discovery of preventive measures and therapy. Tissue samples (caudate nucleus) were obtained from post-mortem CP cases (n = 9) and age- and gender-matched control subjects (n = 11). We employed a targeted metabolomics approach using both 1H NMR and direct injection liquid chromatography-tandem mass spectrometry (DI/LC-MS/MS). We accurately identified and quantified 55 metabolites using 1H NMR and 186 using DI/LC-MS/MS. Among the 222 detected metabolites, 27 showed significant concentration changes between CP cases and controls. Glycerophospholipids and urea were the most commonly selected metabolites used to develop predictive models capable of discriminating between CP and controls. Metabolomics enrichment analysis identified folate, propanoate, and androgen/estrogen metabolism as the top three significantly perturbed pathways. We report for the first time the metabolomic profiling of post-mortem brain tissue from patients who died from cerebral palsy. These findings could help to further investigate the complex etiopathophysiology of CP while identifying predictive, central biomarkers of CP.

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Protection of brain development by antenatal magnesium sulphate for infants born preterm

Cited by 22 publications

References 39 publications

Incidence and Risk Factors for Hypoglycemia During Fetal-to-Neonatal Transition in Premature Infants

Incidence and Risk Factors for Hypoglycemia During Fetal-to-Neonatal Transition in Premature Infants

Effect of Neuroprotective Magnesium Sulfate Treatment on Brain Transcription Response to Hypoxia Ischemia in Neonate Mice

Metabolomic Profiling of Cerebral Palsy Brain Tissue Reveals Novel Central Biomarkers and Biochemical Pathways Associated with the Disease: A Pilot Study

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