Role of Magnesium Sulphate in Newborns With Birth Asphyxia.

Abstract

Background; Birth asphyxia is a leading cause of mortality and morbidity in neonates in developing countries, with an incidence of 100-250/1000 live births compared to 5-10/1000 live births in the developed world. It remains a significant cause of loss of life and adverse developmental outcome. Objective; To compare magnesium sulphate therapy versus placebo in control of fits among newborns admitted with birth asphyxia along with fits at a tertiary care hospital. Material and Methods; All the study (n=260) participants of either sex who met inclusion of this study were who are admitted with birth asphyxia. Group A was study group and was treated with magnesium sulfate in a dose of 250 mg/kg initially within six hours of birth followed by 250 mg/kg at 24 and 48 h of birth while group B (control group) was not given MgSO4 therapy and were observed for control of fits and was given standard treatment. Results; Of these 260 study cases, 139 (53.5 %) were male patients while 121 (46.5 %) were female patients. Mean age of our study cases was 3.84 ± 1.47 hours. Of these 260 study cases, 177 (68.1%) belonged to rural areas and 83 (31.9 %) belonged to urban areas. Of these 260 study cases, home delivery was noted in 91 (35.0%), 149 (57.3%) in private clinics / hospital and 20 (7.7%) in teaching hospital. Mean gestational age of our study cases was 38.23 ± 2.38 and preterm births were noted in 91 (35.0%) of our study cases. Of these 260 study cases, control of fits were noted in 173 (66.5%) while control of fits in group A were noted in 105 (80.8%) and in group B it was 68 (52.3%) (p = 0.000). Conclusion; Our study results support the use of Magnesium Sulphate in control of fits in children with birth asphyxia. Magnesium sulphate was safe, reliable and having no side effect so it can be used safely in these patients to reduce morbidity and mortality. All clinicians treating such patients can employ this treatment modality having safety and efficacy.

Neonatal magnesium sulphate for neuroprotection: A systematic review and meta‐analysis

“…Other searching identified a further 13 records to screen; we excluded two. Therefore, we included 29 studies (reported across 35 references) 29–63 . A study flow diagram is shown in Figure S1; Appendix S2 lists the records excluded at the full‐text screening.…”

“…Of the 29 studies included, 25 were RCTs, 29–47, 49–51, 53–61 and four were non‐RCTs (two were non‐randomized trials and two were non‐concurrent cohort studies); 48, 52, 62, 63 three were available as abstracts only 33, 40, 50 . Twenty‐three studies were conducted exclusively in LMICs (nine in India; 31, 32, 35, 46, 47, 51, 58, 60, 62 eight in Pakistan; 30, 42, 43, 49, 56, 57, 59, 61 three in Egypt; 29, 33, 44 one each in Bangladesh, 40 Nigeria, 52 and Albania 50 ); five in HICs (two in Poland; 39, 63 one each in the Netherlands 36 and Japan; 41 one across five European centres 48 ); and one across mixed settings (Qatar, Turkey, Saudi Arabia, Egypt, Malaysia, and the United Arab Emirates 55 ). Where reported, study commencement dates ranged from 1995 36 to 2021 43, 57 .…”

“…Where reported, study commencement dates ranged from 1995 36 to 2021 43, 57 . Twelve studies (41.4%) were published in the last 5 years 29, 30, 33, 39, 42, 43, 47, 51, 52, 57, 59, 61 …”

“…There were 2099 infants randomized in the 25 RCTs, 29–47, 49–51, 53–61 and 871 infants in the non‐randomized studies 48, 52, 62, 63 . The number of infants per RCT ranged from 22 36 to 260 30 .…”

“…There were 2099 infants randomized in the 25 RCTs, 29–47, 49–51, 53–61 and 871 infants in the non‐randomized studies 48, 52, 62, 63 . The number of infants per RCT ranged from 22 36 to 260 30 . Infants in the studies varied substantially according to gestational age, criteria for asphyxia, and presence of HIE (including severity).…”