Antenatal Magnesium and Cerebral Palsy in Preterm Infants.

MedStar author(s):
Citation: Journal of Pediatrics. 167(4):834-839.e3, 2015 Oct.PMID: 26254839Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology, Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | Randomized Controlled Trial | Research Support, N.I.H., ExtramuralSubject headings: *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] | PregnancyYear: 2015Local holdings: Available online from MWHC library: 1995 - presentISSN:
  • 1097-6833
Name of journal: The Journal of pediatricsAbstract: 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.All authors: Bulas D, Caritis SN, Carpenter MW, DiPietro M, Dudley D, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Hankins GD, Hirtz DG, Iams JD, Malone FD, Mercer BM, O'Sullivan MJ, Peaceman AM, Ramin SM, Reddy UM, Rouse DJ, Seibert J, Sorokin Y, Thorp JM Jr, Varner MW, Wapner RJ, Weiner SJFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-01-15
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26254839 Available 26254839

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.

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