Evaluation of early and late neurodevelopmental outcomes in infants of mothers who used MgSO4 for neuroprotection during early preterm pregnancy

ABSTRACT Evaluation of early and late neurodevelopmental outcomes in infants of mothers who used MgSO4 for neuroprotection during early preterm pregnancy INTRODUCTION AND AIM: Early preterm birth can lead to neurodevelopmental issues in newborns. Administering magnesium sulfate antenatally for 24 hours has been shown to prevent these outcomes, although delivery often occurs before the full 24-hour treatment is completed. This study aimed to evaluate the early and late neurodevelopmental outcomes in preterm infants who were exposed to antenatal MgSO₄. MATERIALS AND METHODS: Between January 2019 and December 2022, infants born before 32 weeks of gestation at Sakarya University Training and Research Hospital were screened. Only infants who received antenatal MgSO₄ were included. The study group was divided into three subgroups: those who received the standard 24-hour dose, those who received it for a shorter duration, and those delivered after a certain interval post-treatment. A control group of infants who did not receive MgSO₄ was also included. The study assessed the duration of MgSO₄ administration, gestational age, and serum magnesium levels. Late neurodevelopmental outcomes were measured using the Denver-2 test. RESULTS: No significant differences were observed between groups in maternal age, obstetric status, parity, or gestational age. However, significant differences were found regarding NICU stay duration, APGAR scores, serum magnesium levels, and the personal-social, motor, and language development domains of the Denver-2 test. Among infants born between 24 and 28 weeks of gestation, no significant differences were found in fine motor, gross motor, language development, and impairments in walking, hearing, vision, and speech between the study and control groups. All infants in the control group exhibited early and late signs of cerebral palsy. CONCLUSION: In preterm infants whose mothers received antenatal MgSO₄, significant differences were observed in both early and late developmental outcomes, including APGAR scores, ICU stay, early sepsis, NEC, ROP, and cerebral palsy, with differences related to the duration of MgSO₄ administration. Keywords: Preterm birth, Denver-2, MgSO₄, Neurodevelopment, APGAR