Antenatal Magnesium and Cerebral Palsy in Preterm Infants

on behalf of the, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design In a randomized trial of MgSO4 or placebo in women at high risk of preterm delivery, up to 3 cranial ultrasounds were obtained in the neonatal period. Images were reviewed by at least 2 pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at 2 years of age by standardized neurologic examination. Results Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 administration did not affect the risk of cranial ultrasound abnormality observed at 35 weeks postmenstrual age or later. However, for the 82% of infants born at <32 weeks gestation, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (P = .04), and for echodensity explained 20% of the effect (P = .02). Conclusions MgSO4 given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at <32 weeks gestation. However, this effect can only partially explain the effect of MgSO4 on CP at 2 years of age. Trial Registration ClinicalTrials.gov: NCT00014989.

Original languageEnglish (US)
Pages (from-to)834-839.e3
JournalJournal of Pediatrics
Volume167
Issue number4
DOIs
StatePublished - Oct 1 2015

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Cerebral Palsy
Premature Infants
Magnesium
Periventricular Leukomalacia
Risk Reduction Behavior
Hemorrhage
Pregnancy
Magnesium Sulfate
Neurologic Examination
Placebos
Mothers
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

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on behalf of the, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, & Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network (2015). Antenatal Magnesium and Cerebral Palsy in Preterm Infants. Journal of Pediatrics, 167(4), 834-839.e3. https://doi.org/10.1016/j.jpeds.2015.06.067

Antenatal Magnesium and Cerebral Palsy in Preterm Infants. / on behalf of the; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.

In: Journal of Pediatrics, Vol. 167, No. 4, 01.10.2015, p. 834-839.e3.

Research output: Contribution to journalArticle

on behalf of the, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network & Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network 2015, 'Antenatal Magnesium and Cerebral Palsy in Preterm Infants', Journal of Pediatrics, vol. 167, no. 4, pp. 834-839.e3. https://doi.org/10.1016/j.jpeds.2015.06.067
on behalf of the, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Antenatal Magnesium and Cerebral Palsy in Preterm Infants. Journal of Pediatrics. 2015 Oct 1;167(4):834-839.e3. https://doi.org/10.1016/j.jpeds.2015.06.067
on behalf of the ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. / Antenatal Magnesium and Cerebral Palsy in Preterm Infants. In: Journal of Pediatrics. 2015 ; Vol. 167, No. 4. pp. 834-839.e3.
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abstract = "Objective To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design In a randomized trial of MgSO4 or placebo in women at high risk of preterm delivery, up to 3 cranial ultrasounds were obtained in the neonatal period. Images were reviewed by at least 2 pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at 2 years of age by standardized neurologic examination. Results Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 administration did not affect the risk of cranial ultrasound abnormality observed at 35 weeks postmenstrual age or later. However, for the 82{\%} of infants born at <32 weeks gestation, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21{\%} of the effect of MgSO4 on CP (P = .04), and for echodensity explained 20{\%} of the effect (P = .02). Conclusions MgSO4 given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at <32 weeks gestation. However, this effect can only partially explain the effect of MgSO4 on CP at 2 years of age. Trial Registration ClinicalTrials.gov: NCT00014989.",
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T1 - Antenatal Magnesium and Cerebral Palsy in Preterm Infants

AU - on behalf of the

AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

AU - Hirtz, Deborah G.

AU - Weiner, Steven J.

AU - Bulas, Dorothy

AU - DiPietro, Michael

AU - Seibert, Joanna

AU - Rouse, Dwight J.

AU - Mercer, Brian M.

AU - Varner, Michael W.

AU - Reddy, Uma M.

AU - Iams, Jay D.

AU - Wapner, Ronald J.

AU - Sorokin, Yoram

AU - Thorp, John M.

AU - Ramin, Susan M.

AU - Malone, Fergal D.

AU - Carpenter, Marshall W.

AU - O'Sullivan, Mary J.

AU - Peaceman, Alan M.

AU - Hankins, Gary D.V.

AU - Dudley, Donald

AU - Caritis, Steve N.

AU - Hauth, John C.

AU - Todd, Allison

AU - Hill, Tawanda

AU - Harris, Stacy

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AU - Jensen, Marla K.

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AU - Fullmer, Lisa H.

AU - Guzman, Anna M.

AU - Collin, Marc

AU - VanBuren, George

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AU - Curry, Valerie

AU - Meadows, Sandra

AU - Sciscione, Anthony

AU - DiVito, Michelle

AU - Talucci, Mary

AU - Desai, Shobhana A.

AU - Paul, David A.

AU - Sibai, Baha M.

AU - Ramsey, Risa D.

AU - Ramsey, Risa

PY - 2015/10/1

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N2 - Objective To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design In a randomized trial of MgSO4 or placebo in women at high risk of preterm delivery, up to 3 cranial ultrasounds were obtained in the neonatal period. Images were reviewed by at least 2 pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at 2 years of age by standardized neurologic examination. Results Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 administration did not affect the risk of cranial ultrasound abnormality observed at 35 weeks postmenstrual age or later. However, for the 82% of infants born at <32 weeks gestation, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (P = .04), and for echodensity explained 20% of the effect (P = .02). Conclusions MgSO4 given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at <32 weeks gestation. However, this effect can only partially explain the effect of MgSO4 on CP at 2 years of age. Trial Registration ClinicalTrials.gov: NCT00014989.

AB - Objective To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design In a randomized trial of MgSO4 or placebo in women at high risk of preterm delivery, up to 3 cranial ultrasounds were obtained in the neonatal period. Images were reviewed by at least 2 pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at 2 years of age by standardized neurologic examination. Results Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 administration did not affect the risk of cranial ultrasound abnormality observed at 35 weeks postmenstrual age or later. However, for the 82% of infants born at <32 weeks gestation, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (P = .04), and for echodensity explained 20% of the effect (P = .02). Conclusions MgSO4 given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at <32 weeks gestation. However, this effect can only partially explain the effect of MgSO4 on CP at 2 years of age. Trial Registration ClinicalTrials.gov: NCT00014989.

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