PEDIATRICS Vol. 99 No. 4 April 1997, pp. e2 (doi:10.1542/peds.99.4.e2)
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PEDIATRICS Vol. 99 No. 4 April 1997, p. e2
Copyright ©1997 by the American Academy of Pediatrics

ELECTRONIC ARTICLE:
Maternal Receipt of Magnesium Sulfate Does Not Seem to Reduce the Risk of Neonatal White Matter Damage

Received Apr 1, 1996; accepted Aug 20, 1996.

Alan Leviton*, Dagger , Nigel Paneth§, Mervyn Susserpar , M. Lynn Reusspar , Elizabeth N. Allred*, Karl Kuban*, Dagger , Ulana Sanockapar , , Thomas Hegyi#, **, Mark Hiatt#, **, Farrokh Shahrivarpar , Dagger Dagger , and Linda J. Van MarterDagger , §§

From * Children's Hospital and Dagger  Harvard Medical School, Boston, Massachusetts; § Michigan State University, East Lansing, Michigan; par  Columbia University, New York, New York;  Babies' Hospital, New York, New York; # St Peter's Medical Center, New Brunswick, New Jersey; ** Robert Wood Johnson Medical School, New Brunswick, New Jersey; Dagger Dagger  St Luke's-Roosevelt Medical Center, New York, New York; and §§ Brigham and Women's Hospital, Boston, Massachusetts.

Objective.  To investigate whether in utero exposure to magnesium sulfate is associated with a lower incidence of cranial ultrasonographic abnormalities that predict cerebral palsy in infants who weigh less than 1501 g at birth.

Design.  For a prospective study of the antecedents of cranial ultrasonographic abnormalities, we enrolled infants who weighed 500 to 1500 g when born at five institutions. Data were collected by interview of the mothers and review of medical records. Protocol cranial ultrasonograms were obtained as close as possible to postnatal days 1, 7, and 21. Abnormality on cranial ultrasound scans was determined by a consensus committee of three sonologists.

Results.  Of the 1518 infants for whom we knew whether the mothers received magnesium sulfate, the first protocol cranial ultrasound scan was available for 1409 infants, the second for 1274 infants, and the third for 1050 infants. Forty-five percent of infants were exposed to magnesium sulfate before delivery. The major correlates of magnesium sulfate exposure were receipt of antenatal corticosteriods and a diagnosis of preeclampsia and/or pregnancy-induced hypertension. Maternal magnesium receipt was not associated with a reduced incidence of hypoechoic or hyperechoic images of white matter parenchyma, intraventricular hemorrhage, or ventriculomegaly, even when the sample was stratified by each of six potential confounders. When adjustment was made for gestational age, a measure of birth weight for gestational age, antenatal corticosteroid exposure, preeclampsia and pregnancy-induced hypertension, route of delivery, and the occurrence of any labor, the risk ratios for each cranial ultrasonographic abnormality associated with magnesium sulfate exposure hovered close to 1.

Conclusion.  Maternal receipt of magnesium sulfate does not seem to be associated with an appreciably reduced risk of cranial ultrasonographically defined neonatal white matter damage, intraventricular hemorrhage, or ventriculomegaly. low birth weight, magnesium sulfate, periventricular leukomalacia, antenatal corticosteriods, intraventricular hemorrhage, pregnancy-induced hypertension.




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