Effect of Cord Blood Magnesium Level at Birth on Non-neurologic Neonatal Outcomes

Edwards, James M.; Edwards, Laura; Swamy, Geeta K.; Grotegut, Chad A.

doi:10.1055/s-0038-1627097

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…However, two larger reports by the Pediatrix Medical Group and the Canadian Neonatal Network showed no increase in NEC or SIP in relationship to any antenatal MgSO 4 exposure 13,14 . Recent meta-analysis and publications also supported these results 9,15,16 . As most evidences regarding association of antenatal MgSO 4 with gastrointestinal complications have been controversial, the role of antenatal MgSO 4 in association with gastrointestinal complications is not well established yet 8 .…”

mentioning

confidence: 64%

“…Previous studies reporting the association of antenatal MgSO 4 with NEC and/or SIP have included extremely preterm babies born at less than 25-26 weeks of gestation 11,12 . Other studies reporting a lack of association between antenatal MgSO 4 treatment and NEC or SIP have included preterm infants born at ≤ 28-34 weeks of gestation [13][14][15][16] . We included infants born at 24-31 weeks of gestation, because the indication of antenatal MgSO 4 treatment protocol for fetal neuroprotection in our institute was those who were at risk of preterm birth at 24-31 weeks of gestation, and the objective of this study was to investigate whether these protocol changes might have any effect on the risk of NEC in this population.…”

Section: Discussionmentioning

confidence: 99%

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Antenatal magnesium sulfate treatment and risk of necrotizing enterocolitis in preterm infants born at less than 32 weeks of gestation

Hong

Choi

et al. 2020

Sci Rep

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Antenatal magnesium sulfate (MgSo 4) treatment is widely used for fetal neuroprotection in women at risk of preterm delivery. However, some studies have recently suggested that in utero MgSO 4 exposure is associated with an increased risk of necrotizing enterocolitis (NEC). This study aimed to investigate the association between antenatal MgSO 4 treatment and risk of nec. this retrospective cohort study included 756 infants born at 24-31 weeks' gestation. Subjects were classified into three groups: period 1, when MgSO 4 treatment protocol for fetal neuroprotection was not adopted (n = 267); period 2, when the protocol was adopted (n = 261); and period 3, when the protocol was withdrawn because of concern of risk of NEC (n = 228). Rates of NEC (≥ stage 2b) were analyzed according to time period and exposure to antenatal MgSo 4. Significant difference in the rate of NEC was not found across the three time periods (2.6% vs. 6.5% vs. 4.8% in periods 1, 2 and 3, respectively, p = 0.103). The rate of NEC was comparable between the infants exposed and unexposed to antenatal MgSO 4 (5.1% vs. 3.6%, p = 0.369). These results showed that antenatal MgSO 4 treatment was not associated with risk of nec in our study population.

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mentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Antenatal magnesium sulfate treatment and risk of necrotizing enterocolitis in preterm infants born at less than 32 weeks of gestation

Hong

Choi

et al. 2020

Sci Rep

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“…[12] However, another secondary analysis of a prospective trial reported that newborns with higher magnesium levels did not show any adverse non-neurological effects. [19] Moreover, a meta-analysis of 5 randomized controlled studies concluded that there were no statistically signi cant differences in neonatal secondary outcomes, such as IVH, periventricular leukomalacia, NEC, RDS, ROP or chronic lung disease. [20] In the aforementioned secondary analysis study, although the combined outcome of death and severe NEC was associated with maternal antenatal MgSO 4 administration in infants who were GA less than 26 weeks, NEC alone was not associated with antenatal MgSO 4 .…”

Section: Discussionmentioning

confidence: 99%

Antenatal Magnesium Sulfate Reduced Intestinal Morbidities Requiring Surgery in Preterm Infants With Extremely Low Gestational Age: A Retrospective Cohort Study

Kim¹,

Kim²,

Shin³

et al. 2020

Preprint

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Background Antenatal magnesium sulfate is widely used as a tocolytic, for maternal seizures, and for seizure prophylaxis in preeclampsia. Recent studies have suggested that antenatal magnesium sulfate use is associated with favorable neurodevelopmental outcomes in preterm infants. However, there are concerns regarding the neonatal effects of antenatal magnesium sulfate, especially regarding gastrointestinal morbidities. This study aims to explore the effects of antenatal magnesium sulfate on intestinal morbidities requiring surgery in preterm infants.Methods This was a retrospective cohort study of 181 preterm infants who were born at less than 28 weeks of gestational age. Subjects were categorized as infants exposed to antenatal magnesium sulfate and those not exposed to antenatal magnesium sulfate.Results Antenatal magnesium sulfate was associated with a lower incidence of surgical conditions of the intestine (OR 0.393, 95% CI 0.170–0.905). Multivariate analysis showed that the duration of antenatal magnesium sulfate use was associated with surgical conditions of the intestine (adjusted OR 0.766, 95% CI 0.589–0.997). In the < 26 weeks of gestational age subgroup, use of antenatal magnesium sulfate was significantly associated with decreased intestinal morbidities requiring surgery (adjusted OR 0.234, 95% CI 0.060–0.922).Conclusion Antenatal magnesium sulfate use appears to have a protective effect on intestinal morbidities requiring surgery in preterm infants in a duration-dependent manner. Association of antenatal magnesium sulfate use and decreased intestinal morbidities requiring surgery was more distinct in preterm infants < 26 weeks of gestational age.

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“…12 However, another secondary analysis of a prospective trial reported that newborns with higher Mg levels did not show any adverse non-neurological effects. 20 Moreover, a meta-analysis of 5 randomized controlled studies concluded that there were no statistically significant differences in neonatal secondary outcomes, such as IVH, periventricular leukomalacia, NEC, RDS, ROP or chronic lung disease. 21 In the aforementioned secondary analysis study, although the combined outcome of death and severe NEC was associated with maternal antenatal MgSO 4 administration in infants who were GA less than 26 weeks, NEC alone was not associated with antenatal MgSO 4 .…”

Section: + Modelmentioning

confidence: 99%

Antenatal magnesium sulfate and intestinal morbidities in preterm infants with extremely low gestational age

Kim

Shin

et al. 2021

Pediatrics & Neonatology

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Effect of Cord Blood Magnesium Level at Birth on Non-neurologic Neonatal Outcomes

Abstract: Higher cord blood magnesium levels do not appear to have adverse non-neurologic effects on the neonate and may demonstrate improvement in neurologic outcomes.

Cited by 11 publications

References 16 publications

Antenatal magnesium sulfate treatment and risk of necrotizing enterocolitis in preterm infants born at less than 32 weeks of gestation

Antenatal magnesium sulfate treatment and risk of necrotizing enterocolitis in preterm infants born at less than 32 weeks of gestation

Antenatal Magnesium Sulfate Reduced Intestinal Morbidities Requiring Surgery in Preterm Infants With Extremely Low Gestational Age: A Retrospective Cohort Study

Antenatal magnesium sulfate and intestinal morbidities in preterm infants with extremely low gestational age

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