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Neonatal Effects of Maternal Magnesium Sulphate in Late Preterm and Term Pregnancies

  • Arun Ambadkar
  • Madhva PrasadEmail author
  • Anahita R. Chauhan
Original Article
  • 32 Downloads

Abstract

Aim

To compare the clinical, obstetric and neonatal parameters between patients with > 34-week gestation having severe preeclampsia receiving magnesium sulphate and those with > 34-week gestation with preeclampsia but not receiving magnesium sulphate.

Materials and Methods

Single-centre prospective study studied 60 patients in each of the two groups. Magnesium sulphate was administered by Pritchard regimen as per standard protocol. Standard obstetric management was followed for both groups. In the severe preeclampsia/eclampsia group, maternal blood sample was analysed for serum magnesium levels. The duration of exposure, the amount of magnesium sulphate received and time elapsed between last dose of magnesium sulphate and delivery were all noted. Neonatal assessment was done. The various parameters including age, parity, blood pressure, mode of termination of pregnancy, NICU admission rate, incidence of hypotonia in the newborn and other neonatal parameters were tabulated and compared.

Results

The two groups were comparable with respect to age and parity. Need for induction of labour was higher in the group with severe preeclampsia/eclampsia. Rate of LSCS and birth weights were comparable between the two groups. NICU admission rate and incidence of hypotonia were higher in those who received magnesium sulphate. Amount of magnesium sulphate received and total duration of magnesium sulphate did not correlate with NICU admission rates.

Conclusions

Neonatal morbidity, in terms of higher NICU admission rates and hypotonia, is higher in patients receiving magnesium sulphate.

Keywords

Magnesium sulphate Neonatal Neuroprotection Hypotonia NICU admission 

Notes

Acknowledgments

The authors sincerely acknowledge the contribution of Late Dr Jayant S Rege towards this study.

Compliance with Ethical Standards

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Since it was a retrospective review of records, no informed consent was obtained from any patients for being included in the study. This article does not contain any studies with animal subjects.

References

  1. 1.
    Bain ES, Middleton PF, Crowther CA. Maternal adverse effects of different antenatal magnesium sulphate regimens for improving maternal and infant outcomes: a systematic review. BMC Pregnancy Childbirth. BioMed Central 2013;13:195. http://www.ncbi.nlm.nih.gov/pubmed/24139447.
  2. 2.
    Bain E, Bubner T, Ashwood P et al. Implementation of a clinical practice guideline for antenatal magnesium sulphate for neuroprotection in Australia and New Zealand. Aust N Z J Obstet Gynaecol. 2013;53(1):86–9.CrossRefGoogle Scholar
  3. 3.
    Nguyen TMN, Crowther CA, Wilkinson D et al. Magnesium sulphate for women at term for neuroprotection of the fetus. Cochrane Database Syst Rev. 2013.  https://doi.org/10.1002/14651858.CD009395.pub2.Google Scholar
  4. 4.
    Drinkwater J. Magnesium sulphate for pre-eclampsia: care of the neonate. Pract Midwife. 2011;14(11):17–9.Google Scholar
  5. 5.
    Greenberg MB, Penn AA, Thomas LJ et al. Neonatal medical admission in a term and late-preterm cohort exposed to magnesium sulfate. Am J Obstet Gynecol. 2011; 204(6):515.e1–515.e7. http://www.ncbi.nlm.nih.gov/pubmed/21376302.
  6. 6.
    Greenberg MB, Penn AA, Whitaker KR et al. Effect of magnesium sulfate exposure on term neonates. J Perinatol. 2013;33(3):188–93.CrossRefGoogle Scholar
  7. 7.
    Girsen AI, Greenberg MB, El-Sayed YY et al. Magnesium sulfate exposure and neonatal intensive care unit admission at term. J Perinatol. 2015;35(3):181–5.CrossRefGoogle Scholar
  8. 8.
    Das M, Chaudhuri P, Mondal B et al. Assessment of serum magnesium levels and its outcome in neonates of eclamptic mothers treated with low-dose magnesium sulfate regimen. Indian J Pharmacol. 2015;47(5):502.CrossRefGoogle Scholar
  9. 9.
    Abbassi-Ghanavati M, Alexander J, McIntire D et al. Neonatal effects of magnesium sulfate given to the mother. Am J Perinatol. 2012;29(10):795–800.CrossRefGoogle Scholar
  10. 10.
    Havranek T, Ashmeade TL, Afanador M et al. Effects of maternal magnesium sulfate administration on intestinal blood flow velocity in preterm neonates. Neonatology. 2011;100(1):44–9.CrossRefGoogle Scholar
  11. 11.
    Sherwin CMT, Balch A, Campbell SC et al. Maternal magnesium sulphate exposure predicts neonatal magnesium blood concentrations. Basic Clin Pharmacol Toxicol. 2014;114(4):318–22.CrossRefGoogle Scholar
  12. 12.
    Drassinower D, Friedman AM, Levin H et al. Does magnesium exposure affect neonatal resuscitation? Am J Obstet Gynecol. 2015; 213(3):424.e1–424.e5. http://www.ncbi.nlm.nih.gov/pubmed/26026919.
  13. 13.
    Yokoyama K, Takahashi N, Yada Y et al. Prolonged maternal magnesium administration and bone metabolism in neonates. Early Hum Dev. 2010;86(3):187–91.CrossRefGoogle Scholar
  14. 14.
    Duffy CR, Odibo AO, Roehl KA et al. Effect of magnesium sulfate on fetal heart rate patterns in the second stage of labor. Obstet Gynecol. 2012;119(6):1129–36.CrossRefGoogle Scholar
  15. 15.
    Chaudhuri S, Bhattacharyya N, Biswas PK et al. Comparison of intramuscular magnesium sulfate with low dose intravenous magnesium sulfate regimen for treatment of eclampsia. J Obstet Gynaecol Res. 2009;35(1):119–25.CrossRefGoogle Scholar
  16. 16.
    Tudela CM, McIntire DD, Alexander JM. Effect of maternal body mass index on serum magnesium levels given for seizure prophylaxis. Obstet Gynecol. 2013;121(2):314–20.CrossRefGoogle Scholar
  17. 17.
    Brookfield KF, Su F, Elkomy MH et al. Pharmacokinetics and placental transfer of magnesium sulfate in pregnant women. Am J Obstet Gynecol. 2016; 214(6):737.e1–737.e9. http://www.ncbi.nlm.nih.gov/pubmed/26767791.
  18. 18.
    Long Q, Oladapo O, Leathersich S et al. Clinical practice patterns on the use of magnesium sulphate for treatment of pre-eclampsia and eclampsia: a multi-country survey. BJOG. 2016. http://www.ncbi.nlm.nih.gov/pubmed/27885772.
  19. 19.
    Berhan Y, Berhan A. Should magnesium sulfate be administered to women with mild pre-eclampsia? A systematic review of published reports on eclampsia. J Obstet Gynaecol Res. 2015;41(6):831–42.CrossRefGoogle Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2017

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologySeth GS Medical College and KEM HospitalMumbaiIndia

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