Neonatal effects of maternal magnesium sulfate therapy

Background: Antenatal magnesium sulfate (MgSO4) therapy is a widely used treatment by obstetricians for neuroprotection, seizure prophylaxis in preeclampsia, and tocolysis. Studies conducted in terms of the effects of this treatment on the newborn have conflicting results. In this study, we aimed to examine the effects of antenatal MgSO4 exposure on babies followed up by our unit. Materials and methods: In our study, the data of babies born at 23 - 36 + 6/7 weeks gestation and their mothers were analyzed retrospectively. Death in the first day, major congenital anomaly or chromosomal anomaly, asphytic birth and presence of chorioamnionitis in the mother, referral to an external center were accepted as exclusion criteria. Those who received antenatal MgSO4 therapy were considered as the "study" group, and those who did not, as the "control" group. The correlation between antenatal MgSO4 therapy with clinical problems (primary adaptation processes in infants, respiratory, nutrition, hemodynamic related problems, patent ductus arteriosus (PDA), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), seizure, sepsis, jaundice, intensive care hospitalization time, death, etc.) was examined. As a secondary inference, the correlation between these clinical data with the treatment protocol, mother and baby laboratory findings in the group receiving MgSO4 therapy was examined. In order to minimize the difference in gestational age, patients were subdivided into <28 weeks of gestation (GW), 28-33 + 6/7 GW, 34-36 + 6/7 GW. Results: Of the 180 babies, 106 (58.9%) were in the study and 74 (41.1%) were in the control group. In the <28 GW group, it was found that the duration of total respiratory support and hospitalization in the intensive care unit prolonged significantly with the MgSO4 treatment duration and the cumulative treatment dose. It was observed that the frequency of bronchopulmonary dysplasia (BPD), IVH and jaundice development in babies decreased significantly with MgSO4 treatment in the 28 - 33+6/7 GW group. Otherwise cord blood Mg levels were found to be associated with an increase in hypotonicity and BPD frequency, but the 24th hour Mg level was more significant in predicting respiratory problems in this group. There was no significant relationship between other clinical parameters and MgSO4 treatment. Conclusions: In this study we conclude MgSO4 therapy could be associated with an increase in respiratory problems such as RDS and BPD in preterms, and a decrease in neurological complications such as IVH. Keywords: magnesium sulfate; maternal; neonatal; preterm; newborn; treatment protocol