Antenatal Magnesium and Cerebral Palsy in Preterm Infants.
Antenatal Magnesium and Cerebral Palsy in Preterm Infants.
- 2015
Available online from MWHC library: 1995 - present
CONCLUSIONS: MgSO4 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 MgSO4 on CP at 2 years of age. OBJECTIVE: To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). RESULTS: Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 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, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (P = .04), and for echodensity explained 20% of the effect (P = .02). STUDY DESIGN: In a randomized trial of MgSO4 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. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00014989.Copyright Published by Elsevier Inc.
English
1097-6833
*Cerebral Palsy/bl [Blood]
*Cerebral Palsy/us [Ultrasonography]
*Magnesium Sulfate/tu [Therapeutic Use]
Cerebral Hemorrhage/us [Ultrasonography]
Cerebral Palsy/pc [Prevention & Control]
Cerebral Ventricles/us [Ultrasonography]
Child, Preschool
Cohort Studies
Electroencephalography
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Leukomalacia, Periventricular/us [Ultrasonography]
Male
Maternal Exposure
Neuroprotective Agents/tu [Therapeutic Use]
Pregnancy
MedStar Washington Hospital Center
Obstetrics and Gynecology, Maternal-Fetal Medicine
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Available online from MWHC library: 1995 - present
CONCLUSIONS: MgSO4 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 MgSO4 on CP at 2 years of age. OBJECTIVE: To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). RESULTS: Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 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, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (P = .04), and for echodensity explained 20% of the effect (P = .02). STUDY DESIGN: In a randomized trial of MgSO4 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. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00014989.Copyright Published by Elsevier Inc.
English
1097-6833
*Cerebral Palsy/bl [Blood]
*Cerebral Palsy/us [Ultrasonography]
*Magnesium Sulfate/tu [Therapeutic Use]
Cerebral Hemorrhage/us [Ultrasonography]
Cerebral Palsy/pc [Prevention & Control]
Cerebral Ventricles/us [Ultrasonography]
Child, Preschool
Cohort Studies
Electroencephalography
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Leukomalacia, Periventricular/us [Ultrasonography]
Male
Maternal Exposure
Neuroprotective Agents/tu [Therapeutic Use]
Pregnancy
MedStar Washington Hospital Center
Obstetrics and Gynecology, Maternal-Fetal Medicine
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural