Effects of long‐term antenatal magnesium sulfate administration on the bone mineralization of preterm infants

Abstract

Aim To evaluate the relationship between long‐term antenatal magnesium sulfate (MgSO4) administration and neonatal bone mineralization. Methods Infants born at 28–33 weeks of gestation (n = 163) were divided into three groups: long‐term Mg administration group (infants received antenatal MgSO4 for ≥40 days), short‐term Mg administration group (infants received antenatal MgSO4 for <40 days), and non‐Mg group. Serum calcium, phosphorus, Mg, and alkaline phosphatase were measured weekly up to 1 month of age, and the bone speed of sound (SOS) values were measured using quantitative ultrasound (QUS) at 1 week and 1 month after birth. Results In the long‐term Mg administration group, the serum calcium values were significantly lower, and the serum phosphorus, Mg, and alkaline phosphatase values were significantly higher than those in the non‐Mg group at birth. Although these biochemical differences disappeared around the age of 2 weeks, the SOS values of the long‐term Mg administration group were significantly lower than those of the non‐Mg group both at 1 week and 1 month after birth (p = 0.02 and <0.001, respectively). When less than 10th percentile of SOS values at 1 month after birth in the non‐Mg group was defined as poor bone mineralization, the cut‐off value for the duration of antenatal MgSO4 administration was 67 days. Conclusions Long‐term antenatal MgSO4 administration affects bone mineralization during the early neonatal period, but the clinically acceptable duration of the administration based on its effects of bone mineralization assessed with QUS might be longer than a few weeks.

Changing trend of neonatal Ca/P/Mg status in a Chinese population

“…Neonatal hypocalcemic seizures are prone to have worse neurodevelopmental outcomes ( 15 ). The long-term antenatal MgSO 4 administration affected bone mineralization through the fetal and neonatal period ( 16 ). Early parenteral Ca and P supplementation and optimising enteral supplementation with multicomponent fortifiers reduce the incidence of metabolic bone disease ( 17 ).…”