Cerebral Palsy in Very Preterm Infants: A Nine-Year Prospective Study in a French Population-Based Tertiary Center

Chollat, Clément; Bertrand, Emmanuelle; Petit-Ledo, Alice; Vansay, Caroline de; Voisin, Caroline; Dabaj, Ivana; Gillibert, André; Marret, Stéphane; Lévêque, C.; Simenel, J.-L.; Pauthier, S; Levavasseur, C.; I, Pop; Grancher, N.; Lefebure, A.; Vittecoq, C.; Dabbagh, D.; Machevin, E.; Levy, Mélanie; Taleb, Fethi; Lahrach, Hakim; Rhali, H.; Richet, B.; Delaunay, Franck; Bruel, H.; Selim, A.; Jaffray, Mariesha; Durand-Reville, Marc; Sarreau, C.; Çelik, Samettin; Digabel, J.-F. Le; Stoller, Jason Z.; Muszynski, Hélène; Rouha, Mahfoud; Verspyck, É.; Chadi, Alexandre

doi:10.1016/j.jpeds.2021.06.018

Cited by 11 publications

(7 citation statements)

References 26 publications

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“… 32 In a 9-year prospective study, the prevalence of cerebral palsy at 2 years of age in preterm infants with GA < 33 weeks decreased after (2010–2015) the adoption of MgSO 4 for fetal neuroprotection compared to before (2007–2009). 33 However, in that study by Chollat et al, 33 the prevalence of cerebral palsy was not analyzed by direct comparison of infants exposed to antenatal MgSO 4 or not. In addition, the decreased prevalence of cerebral palsy may be related to improvements in NICU care.…”

Section: Discussionmentioning

confidence: 95%

Antenatal Magnesium Sulfate Is Not Associated With Improved Long-Term Neurodevelopment and Growth in Very Low Birth Weight Infants

Jeon,

Ahn,

Kim

et al. 2023

J Korean Med Sci

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Background Though antenatal magnesium sulfate (MgSO 4 ) is widely used for fetal neuroprotection, suspicions about the long-term neuroprotection of antenatal MgSO 4 have been raised. Methods We investigated short- and long-term outcomes of antenatal MgSO4 use for 468 infants weighing < 1,500 g with a gestational age of 24–31 weeks. Results Short-term morbidities and the risk of developmental delay, hearing loss, and cerebral palsy at a corrected age of 18–24 months and 3 years of age did not decrease in the MgSO 4 group (infants who were exposed to MgSO 4 for any purpose) or neuroprotection group (infants who were exposed to MgSO 4 for fetal neuroprotection) compared with the control group (infants who were not exposed to MgSO 4 ). The z-scores of weight, height, and head circumference did not increase in the MgSO 4 group or neuroprotection group compared with the control group. Conclusion Antenatal MgSO 4 including MgSO 4 for neuroprotection did not have beneficial effects on long-term neurodevelopmental and growth outcomes.

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Section: Discussionmentioning

confidence: 95%

Antenatal Magnesium Sulfate Is Not Associated With Improved Long-Term Neurodevelopment and Growth in Very Low Birth Weight Infants

Jeon,

Ahn,

Kim

et al. 2023

J Korean Med Sci

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show abstract

“…Another Australian study showed an increase in women treated from 63% to 86% over a 3 year follow‐up within a quality intervention program 24 . A French study reported 87% of children treated with antenatal MgSO 4 during a 5 year period after implementation of a clinical guideline 25 . A third Australian study reported that 69% of children born 6–7 years after implementation of the medical guideline had received antenatal MgSO 4.…”

Section: Discussionmentioning

confidence: 99%

“…Another limitation, which affects the generalizability of the study, is that we did not have a national, population‐based cohort since we only included five out of six university hospitals accepting extremely preterm births and approximately half of hospitals admitting very preterm births 22 . On the other hand, earlier studies that explored the same area all collected data from only one clinic making our study comparably more comprehensive 23‐26 . Additionally, our data were manually checked and then controlled against the national registers, which strengthens the quality of the data significantly.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… 24 A French study reported 87% of children treated with antenatal MgSO 4 during a 5 year period after implementation of a clinical guideline. 25 A third Australian study reported that 69% of children born 6–7 years after implementation of the medical guideline had received antenatal MgSO 4. 26 The use of maintenance infusion has been reported as a barrier to initiating treatment 18 and could explain why our study reached a higher proportion treated than comparable studies even though our time for follow‐up after implementation was shorter.…”

Section: Discussionmentioning

confidence: 99%

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A follow up on the feasibility after national implementation of magnesium sulfate for neuroprotection prior to preterm birth

Hellström,

Jonsdotter,

Jonsson

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionThe risk for brain injury manifested as cerebral palsy is higher in very preterm born children than in term. Prenatal administration of magnesium sulfate (MgSO4) has been shown to be neuroprotective and reduces the proportion of very preterm born children later diagnosed with cerebral palsy. A Swedish national clinical practice guideline was implemented in March 2020, stipulating the administration of a single intravenous dose of 6 g MgSO4 1–24 h prior to delivery before gestational age 32+0, aiming for 90% treatment coverage. The aim of this study was to evaluate the feasibility of this new clinical practice guideline in the first year of its implementation.Material and methodsData on MgSO4 treatment were collected by reviewing the medical charts of women who gave birth to live born children in gestational age 22+0–31+6 during the period of March 1, 2020 to February 28, 2021, at five Swedish university hospitals. Women with pre‐eclampsia, eclampsia, or high elevated liver enzymes low platelets (HELLP) were excluded.ResultsA total of 388 women were eligible and 79% received treatment with MgSO4. Of the 21% not receiving treatment, 9% did not receive treatment due to lack of knowledge about the clinical practice guideline, 9% were not possible to treat and 3% had missing data. The proportion treated increased from 72% to 87% from the first to the last 3 months. Of those treated, 81% received the drug within the stipulated timeframe (mean 8.7 h, median 3.4 h).ConclusionsThere was a positive trend over time in the proportion of women receiving MgSO4 treatment, but the a priori target of 90% was not reached during the first year of implementation. Our findings indicate that this target could be reached with additional information to clinicians.

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Low-Dose Remifentanil in Preterm Cesarean Section with General Anesthesia: A Randomized Controlled Trial

Chollat,

Tourrel,

Houivet

et al. 2023

Pediatr Drugs

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Cerebral Palsy in Very Preterm Infants: A Nine-Year Prospective Study in a French Population-Based Tertiary Center

Cited by 11 publications

References 26 publications

Antenatal Magnesium Sulfate Is Not Associated With Improved Long-Term Neurodevelopment and Growth in Very Low Birth Weight Infants

Antenatal Magnesium Sulfate Is Not Associated With Improved Long-Term Neurodevelopment and Growth in Very Low Birth Weight Infants

A follow up on the feasibility after national implementation of magnesium sulfate for neuroprotection prior to preterm birth

Low-Dose Remifentanil in Preterm Cesarean Section with General Anesthesia: A Randomized Controlled Trial

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