Faculty Collaboration Database

Association of duration of neuroprotective magnesium sulfate infusion with neonatal and maternal outcomes. Obstet Gynecol 2014 Oct;124(4):749-755

Date

09/10/2014

Pubmed ID

25198275

DOI

10.1097/AOG.0000000000000467

Scopus ID

2-s2.0-84925221822 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

OBJECTIVE: To evaluate the association of duration of magnesium sulfate infusion with stillbirth or death, cerebral palsy, and select adverse maternal and neonatal outcomes.

METHODS: This is a secondary cohort analysis of women randomized to receive magnesium sulfate within a previously reported Maternal-Fetal Medicine Units Network prospective clinical trial. The association of antenatal infusion of magnesium sulfate for less than 12 hours, 12-18 hours, and greater than 18 hours on maternal and perinatal outcomes was compared. The primary outcome was cerebral palsy of any severity or death. Secondary outcomes included cerebral palsy, death, and select maternal and neonatal outcomes. Stratified and logistic regression analyses were used. The models were adjusted for race, gestational age at birth, time since last magnesium sulfate, any magnesium sulfate at delivery, and eligibility criteria as appropriate.

RESULTS: Of 933 women available for analysis, 356, 341, and 236 received antenatal magnesium sulfate infusion for a total of less than 12 hours, 12-18 hours, or greater than 18 hours, respectively. Any cerebral palsy or death occurred in 39 women (11.7%) who received magnesium sulfate less than 12 hours, 34 women (10.3%) who received 12-18 hours of magnesium sulfate, and 20 women (8.8%) who received greater than 18 hours of magnesium sulfate. There was no difference in death or cerebral palsy among groups (less than 12 hours as reference; adjusted odds ratio [OR] 1.03, 95% confidence interval [CI] 0.60-1.77 for 12-18 hours; adjusted OR 1.08, 95% CI 0.57-2.03 for greater than 18 hours). Select maternal adverse drug affects and neonatal morbidities were also similar across groups.

CONCLUSION: The duration of antenatal magnesium sulfate infusion is not associated with risk of death or cerebral palsy. The optimal treatment duration needed for maximal neuroprotection remains unknown.

LEVEL OF EVIDENCE: : II.

Author List

McPherson JA, Rouse DJ, Grobman WA, Palatnik A, Stamilio DM

Author

Anna Palatnik MD Associate Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Apgar Score
Birth Weight
Cerebral Palsy
Confidence Intervals
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Gestational Age
Humans
Infant
Infant Mortality
Infant, Newborn
Infusions, Intravenous
Logistic Models
Magnesium Sulfate
Male
Maternal Welfare
Neuroprotective Agents
Odds Ratio
Pregnancy
Pregnancy Outcome
Premature Birth
Prenatal Care
Prospective Studies
Risk Assessment
Treatment Outcome