Randomized controlled trial of magnesium sulfate in women at risk of preterm delivery—neonatal cardiovascular effects

Paradisis, Mary; Osborn, David A; Evans, Nicholas J.; Kluckow, Martin

doi:10.1038/jp.2011.168

Cited by 20 publications

(14 citation statements)

References 29 publications

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“…While magnesium results in vasodilatation and reduced vascular reactivity (21), our data are consistent with the sole study of cardiovascular function following MgSO 4 use for neuroprotection in infants of a comparable gestational age (12), with no differences in right ventricular output or mean arterial blood pressure observed. Further, we observed no differences in total internal carotid blood flow between the MgSO 4 exposed and nonexposed infants, suggesting this therapy does not impact upon CBF and oxygen delivery.…”

Section: Discussionsupporting

confidence: 74%

“…While increased cerebral blood flow (CBF) velocities have been reported in infants whose mothers received MgSO 4 for the management of pre-eclampsia or tocolysis (9,10) another study has reported significant lowering of neonatal cerebral perfusion (11). The sole study reporting neonatal cardiovascular effects of antenatal MgSO 4 for neuro-protection found no difference in echocardiographic measures of systemic blood flow on the first day of life (12).…”

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confidence: 95%

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Effects of antenatal magnesium sulfate treatment for neonatal neuro-protection on cerebral oxygen kinetics

2015

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Section: Discussionsupporting

confidence: 74%

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confidence: 95%

Effects of antenatal magnesium sulfate treatment for neonatal neuro-protection on cerebral oxygen kinetics

2015

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“…of age among infants exposed to anteMg (N=48) compared to those not exposed (N=39); however, inotrope use did not differ between the two groups. 19 Low systemic blood flow in preterm infants during the first day of life has been known to be associated with decreasing gestational age, increasing mean airway pressure and reduction in myocardial contractility. 20, 21 Exposure to anteMg has been reported to help stabilize blood pressure changes in the first 48 hours of life 22 while volume expansion has been shown to improve the SVC flow among preterm infants; 23 these reports support our findings of lower risk for hypotension treatment among infants in the anteMg group despite having lower GA compared to the noMg group.…”

Section: Commentmentioning

confidence: 99%

Antenatal magnesium sulfate exposure and acute cardiorespiratory events in preterm infants

Jesus

Sood

Shankaran

et al. 2015

American Journal of Obstetrics and Gynecology

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Objective Antenatal magnesium (anteMg) is used for tocolysis, pregnancy-induced hypertension (PIH) and neuroprotection for preterm birth. Infants exposed to anteMg are at risk for respiratory depression and resuscitation in the delivery room (DR). The study objective was to compare the risk of acute cardio-respiratory (CR) events among preterm infants exposed to anteMg and those unexposed (noMg). Study Design This was a retrospective analysis of prospective data collected in the NICHD Neonatal Research Network's Generic Database from 4/1/11 to 3/31/12. The primary outcome was DR intubation or mechanical ventilation (MV) at birth or on day 1 of life. Secondary outcomes were endotracheal MV (eMV), hypotension and other neonatal morbidities and mortality. Logistic regression analysis evaluated the risk of primary outcomes after adjustment for gestational age (GA), center, antenatal steroids (ANS) and PIH/eclampsia. Results We evaluated 1,544 infants <29 weeks GA (1,091 in anteMg group and 453 in noMg group). Mothers in the anteMg group were more likely to have higher education, PIH/eclampsia and ANS; while their infants were younger in gestation and weighed less (P<0.05). The primary outcome, mortality and neonatal morbidities were similar between groups; while eMV and hypotension were significantly less among the anteMg group compared to the noMg group. AnteMg exposure was significantly associated with decreased risk of hypotension on day 1 of life and eMV on day 3 of life in the regression analysis. Conclusion Preterm infants <29 weeks GA who were exposed to anteMg did not suffer worse CR outcomes compared to those without exposure.

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“…of age among infants exposed to anteMg (N=48) compared to those not exposed (N=39); however, inotrope use did not differ between the two groups. 19 Low systemic blood flow in preterm infants during the first day of life has been known to be associated with decreasing gestational age, increasing mean airway pressure and reduction in myocardial contractility. 20,21 Exposure to anteMg has been reported to help stabilize blood pressure changes in the first 48 hours of life 22 while volume expansion has been shown to improve the SVC flow among preterm infants; 23 these reports support our findings of lower risk for hypotension treatment among infants in the anteMg group despite having lower GA compared to the noMg group.…”

Section: Commentmentioning

confidence: 99%

Antenatal Magnesium Sulfate Exposure and Acute Cardiorespiratory Events in Preterm Infants

Jesus

Sood

Shankaran

et al. 2015

Obstetric Anesthesia Digest

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Objective-Antenatal magnesium (anteMg) is used for tocolysis, pregnancy-induced hypertension (PIH) and neuroprotection for preterm birth. Infants exposed to anteMg are at risk for respiratory depression and resuscitation in the delivery room (DR). The study objective was to compare the risk of acute cardio-respiratory (CR) events among preterm infants exposed to anteMg and those unexposed (noMg).Study Design-This was a retrospective analysis of prospective data collected in the NICHD Neonatal Research Network's Generic Database from 4/1/11 to 3/31/12. The primary outcome was DR intubation or mechanical ventilation (MV) at birth or on day 1 of life. Secondary outcomes were endotracheal MV (eMV), hypotension and other neonatal morbidities and mortality. Logistic regression analysis evaluated the risk of primary outcomes after adjustment for gestational age (GA), center, antenatal steroids (ANS) and PIH/eclampsia. Results-We evaluated 1,544 infants <29 weeks GA (1,091 in anteMg group and 453 in noMg group). Mothers in the anteMg group were more likely to have higher education, PIH/eclampsia and ANS; while their infants were younger in gestation and weighed less (P<0.05). The primary outcome, mortality and neonatal morbidities were similar between groups; while eMV and hypotension were significantly less among the anteMg group compared to the noMg group. AnteMg exposure was significantly associated with decreased risk of hypotension on day 1 of life and eMV on day 3 of life in the regression analysis.Conclusion-Preterm infants <29 weeks GA who were exposed to anteMg did not suffer worse CR outcomes compared to those without exposure.

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Randomized controlled trial of magnesium sulfate in women at risk of preterm delivery—neonatal cardiovascular effects

Cited by 20 publications

References 29 publications

Effects of antenatal magnesium sulfate treatment for neonatal neuro-protection on cerebral oxygen kinetics

Effects of antenatal magnesium sulfate treatment for neonatal neuro-protection on cerebral oxygen kinetics

Antenatal magnesium sulfate exposure and acute cardiorespiratory events in preterm infants

Antenatal Magnesium Sulfate Exposure and Acute Cardiorespiratory Events in Preterm Infants

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