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Am J Perinatol 2018; 35(02): 170-176
DOI: 10.1055/s-0037-1606358
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prenatal Therapy with Magnesium Sulfate and Its Correlation with Neonatal Serum Magnesium Concentration

L. García Alonso
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
,
M. Pumarada Prieto
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
,
E. González Colmenero
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
,
A. Concheiro Guisán
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
,
M. Suárez Albo
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
,
C. Durán Fernández-Feijoo
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
,
L. González Durán
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
,
J. R. Fernández Lorenzo
1   Department of Pediatrics, Álvaro Cunqueiro University Hospital, Vigo, Galicia, Spain
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Publikationsverlauf

22. Oktober 2016

30. Juli 2017

Publikationsdatum:
30. August 2017 (online)

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Abstract

Introduction Antenatal magnesium sulfate (MgSO4) administration has shown to be effective in minimizing cerebral palsy and severe motor dysfunction at the age of 2 years. The aim of this study is to determine the relationship between the magnesium dose delivered to the mother and the magnesium concentration in the neonates.

Materials and Methods A prospective cohort study was conducted on neonates of less than 32 weeks' gestation admitted to the neonatal intensive care unit of University Hospital Complex of Vigo from December 2012 to July 2015. Comparative analysis of magnesium levels between the groups of neonates exposed to MgSO4 and the control group.

Results A total of 118 neonates were included in the study. The mothers of 62 of them had received MgSO4 as a neuroprotective agent. There was a significant correlation between the full dose of MgSO4 received by the mother and the levels of magnesium in the neonate in the first 24 hours of life (r 2 = 0.397; p < 0.001).

Conclusion The MgSO4 dose received by the mother has a linear relationship with the magnesium levels obtained in neonates.

Keywords

magnesium sulfate - neuroprotection - serum magnesium concentration - maternal dose
 

  • References

  • 1 Jacobsson B, Hagberg G, Hagberg B, Ladfors L, Niklasson A, Hagberg H. Cerebral palsy in preterm infants: a population-based case-control study of antenatal and intrapartal risk factors. Acta Paediatr 2002; 91 (08) 946-951
    CrossrefPubMedGoogle Scholar
  • 2 Clark SM, Ghulmiyyah LM, Hankins GD. Antenatal antecedents and the impact of obstetric care in the etiology of cerebral palsy. Clin Obstet Gynecol 2008; 51 (04) 775-786
    CrossrefPubMedGoogle Scholar
  • 3 Centers for Disease Control and Prevention (CDC). Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment--United States, 2003. Morb Mortal Wkly Rep 2004; 53 (03) 57-59
    PubMedGoogle Scholar
  • 4 Himmelmann K, Hagberg G, Beckung E, Hagberg B, Uvebrant P. The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth-year period 1995-1998. Acta Paediatr 2005; 94 (03) 287-294
    CrossrefPubMedGoogle Scholar
  • 5 van de Bor M, Verloove-Vanhorick SP, Brand R, Keirse MJ, Ruys JH. Incidence and prediction of periventricular-intraventricular hemorrhage in very preterm infants. J Perinat Med 1987; 15 (04) 333-339
    CrossrefPubMedGoogle Scholar
  • 6 Leviton A, Kuban KC, Pagano M, Brown ER, Krishnamoorthy KS, Allred EN. Maternal toxemia and neonatal germinal matrix hemorrhage in intubated infants less than 1751 g. Obstet Gynecol 1988; 72 (04) 571-576
    PubMedGoogle Scholar
  • 7 Nelson KB, Grether JK. Can magnesium sulfate reduce the risk of cerebral palsy in very low birthweight infants?. Pediatrics 1995; 95 (02) 263-269
    PubMedGoogle Scholar
  • 8 Doyle LW, Crowther CA, Middleton P, Marret S, Rouse D. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database Syst Rev 2009; 1 (01) CD004661
    PubMedGoogle Scholar
  • 9 Doyle LW, Crowther CA, Middleton P, Marret S. Antenatal magnesium sulfate and neurologic outcome in preterm infants: a systematic review. Obstet Gynecol 2009; 113 (06) 1327-1333
    CrossrefPubMedGoogle Scholar
  • 10 Costantine MM, Weiner SJ. ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Effects of antenatal exposure to magnesium sulfate on neuroprotection and mortality in preterm infants: a meta-analysis. Obstet Gynecol 2009; 114 (2 Pt 1): 354-364
    CrossrefPubMedGoogle Scholar
  • 11 Bain E, Middleton P, Crowther CA. Different magnesium sulphate regimens for neuroprotection of the fetus for women at risk of preterm birth. Cochrane Database Syst Rev 2012; 2 (02) CD009302
    PubMedGoogle Scholar
  • 12 McPherson JA, Rouse DJ, Grobman WA, Palatnik A, Stamilio DM. Association of duration of neuroprotective magnesium sulfate infusion with neonatal and maternal outcomes. Obstet Gynecol 2014; 124 (04) 749-755
    CrossrefPubMedGoogle Scholar
  • 13 Mittendorf R, Dammann O, Lee K-S. Brain lesions in newborns exposed to high-dose magnesium sulfate during preterm labor. J Perinatol 2006; 26 (01) 57-63
    CrossrefPubMedGoogle Scholar
  • 14 Basu SK, Chickajajur V, Lopez V, Bhutada A, Pagala M, Rastogi S. Immediate clinical outcomes in preterm neonates receiving antenatal magnesium for neuroprotection. J Perinat Med 2011; 40 (02) 185-189
    PubMedGoogle Scholar
  • 15 Lipsitz PJ, English IC. Hypermagnesemia in the newborn infant. Pediatrics 1967; 40 (05) 856-862
    PubMedGoogle Scholar
  • 16 Rasch DK, Huber PA, Richardson CJ, L'Hommedieu CS, Nelson TE, Reddi R. Neurobehavioral effects of neonatal hypermagnesemia. J Pediatr 1982; 100 (02) 272-276
    CrossrefPubMedGoogle Scholar
  • 17 Green KW, Key TC, Coen R, Resnik R. The effects of maternally administered magnesium sulfate on the neonate. Am J Obstet Gynecol 1983; 146 (01) 29-33
    CrossrefPubMedGoogle Scholar
  • 18 Riaz M, Porat R, Brodsky NL, Hurt H. The effects of maternal magnesium sulfate treatment on newborns: a prospective controlled study. J Perinatol 1998; 18 (6 Pt 1): 449-454
    PubMedGoogle Scholar
  • 19 Satake K, Lee JD, Shimizu H. , et al. Effects of magnesium on prostacyclin synthesis and intracellular free calcium concentration in vascular cells. Magnes Res 2004; 17 (01) 20-27
    PubMedGoogle Scholar
  • 20 Havranek T, Ashmeade TL, Afanador M, Carver JD. Effects of maternal magnesium sulfate administration on intestinal blood flow velocity in preterm neonates. Neonatology 2011; 100 (01) 44-49
    CrossrefPubMedGoogle Scholar
  • 21 Noone D, Kieran E, Molloy EJ. Serum magnesium in the first week of life in extremely low birth weight infants. Neonatology 2012; 101 (04) 274-277
    CrossrefPubMedGoogle Scholar
  • 22 Turitz AL, Too GT, Gyamfi-Bannerman C. Proximity of magnesium exposure to delivery and neonatal outcomes. Am J Obstet Gynecol 2016; 215 (04) 508.e1-508.e6
    CrossrefPubMedGoogle Scholar
  • 23 Borja-Del-Rosario P, Basu SK, Haberman S, Bhutada A, Rastogi S. Neonatal serum magnesium concentrations are determined by total maternal dose of magnesium sulfate administered for neuroprotection. J Perinat Med 2014; 42 (02) 207-211
    PubMedGoogle Scholar
  • 24 Ohhashi M, Yoshitomi T, Sumiyoshi K. , et al. Magnesium sulphate and perinatal mortality and morbidity in very-low-birthweight infants born between 24 and 32 weeks of gestation in Japan. Eur J Obstet Gynecol Reprod Biol 2016; 201: 140-145
    CrossrefPubMedGoogle Scholar
  • 25 Morag I, Yakubovich D, Stern O. , et al. Short-term morbidities and neurodevelopmental outcomes in preterm infants exposed to magnesium sulphate treatment. J Paediatr Child Health 2016; 52 (04) 397-401
    CrossrefPubMedGoogle Scholar
  • 26 Kamyar M, Clark EA, Yoder BA, Varner MW, Manuck TA. Antenatal magnesium sulfate, necrotizing enterocolitis, and death among neonates < 28 weeks gestation. AJP Rep 2016; 6 (01) e148-e154
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 27 Drassinower D, Friedman AM, Levin H, Običan SG, Gyamfi-Bannerman C. Does magnesium exposure affect neonatal resuscitation?. Am J Obstet Gynecol 2015; 213 (03) 424.e1-424.e5
    CrossrefPubMedGoogle Scholar
  • 28 Weisz DE, Shivananda S, Asztalos E. , et al; Canadian Neonatal Network. Intrapartum magnesium sulfate and need for intensive delivery room resuscitation. Arch Dis Child Fetal Neonatal Ed 2015; 100 (01) F59-F65
    CrossrefPubMedGoogle Scholar
  • 29 Ariceta G, Rodríguez-Soriano J, Vallo A. Magnesium homeostasis in premature and full-term neonates. Pediatr Nephrol 1995; 9 (04) 423-427
    CrossrefPubMedGoogle Scholar
  • 30 Vilchez G, Dai J, Lagos M, Sokol RJ. Maternal side effects and fetal neuroprotection according to body mass index after magnesium sulfate in a multicentre randomized controlled trial. J Matern Fetal Neonatal Med 2017; 23: 1-9
    PubMedGoogle Scholar