Neonatal magnesemia in preterm neonates unexposed to maternal MgSO4
administration and in neonates exposed for fetal neuroprotection or
maternal eclampsia prevention: a retrospective cohort study, 2012-2015.
Abstract
Objective - To compare neonatal magnesemia in the first fifteen days of
neonatal life between three groups: a control group not exposed to
MgSO4, a neuroprotection group, and an eclampsia prevention group, and
to explore its’ associations with child outcomes. Design - Retrospective
single-centre cohort study. Setting - Tertiary care setting. Population
- Infants admitted at the neonatal intensive care unit born between 24
and 32 weeks’ gestation, regardless of etiology of preterm birth.
Methods - Linear mixed regression of neonatal magnesemia on exposure
group and day of life. Generalised estimating equations models of child
outcomes on neonatal magnesemia according to exposure group and day of
life. Main outcome measures - Neonatal magnesemia (mmol/l). Results -
Neonatal magnesemia is significantly higher in the preeclampsia group
compared to the control and neuroprotection group. On the day of birth,
this is irrespective of maternal magnesemia (preeclampsia vs control
group), and the maternal total dose or duration of MgSO4 administration
(preeclampsia vs neuroprotection group). No differences were found in
short-term composite outcome between the three groups. Conclusions - We
found mean differences in neonatal magnesemia between children not
exposed to MgSO4 antenatally, children exposed for fetal
neuroprotection, and children exposed for maternal eclampsia prevention.
A 4g loading and 1g/h maintenance dose, for fetal neuroprotection and
eclampsia prevention, appears to be safe on the short term for the
neonate. Funding - Isabelle Dehaene is funded by a scholarship of FWO
(1700520N) Keywords - neonatal magnesemia, neuroprotection,
preeclampsia, preterm birth