Antenatal Magnesium and Cerebral Palsy in Preterm Infants

Academic Article

Abstract

  • Objective To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO ) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design In a randomized trial of MgSO or placebo in women at high risk of preterm delivery, up to 3 cranial ultrasounds were obtained in the neonatal period. Images were reviewed by at least 2 pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at 2 years of age by standardized neurologic examination. Results Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO administration did not affect the risk of cranial ultrasound abnormality observed at 35 weeks postmenstrual age or later. However, for the 82% of infants born at <32 weeks gestation, MgSO was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO on CP (P = .04), and for echodensity explained 20% of the effect (P = .02). Conclusions MgSO given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at <32 weeks gestation. However, this effect can only partially explain the effect of MgSO on CP at 2 years of age. Trial Registration ClinicalTrials.gov: NCT00014989. 4 4 4 4 4 4 4
  • Authors

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    Digital Object Identifier (doi)

    Author List

  • Hirtz DG; Weiner SJ; Bulas D; DiPietro M; Seibert J; Rouse DJ; Mercer BM; Varner MW; Reddy UM; Iams JD
  • Start Page

  • 834
  • End Page

  • 839.e3
  • Volume

  • 167
  • Issue

  • 4