Grether J K, Hoogstrate J, Walsh-Greene E, Nelson K B
March of Dimes Birth Defects Foundation/California Department of Health Services, California Birth Defects Monitoring Program, Auckland, CA 94606, USA.
Am J Obstet Gynecol. 2000 Sep;183(3):717-25. doi: 10.1067/mob.2000.106581.
Our aim was to examine magnesium sulfate tocolysis and cerebral palsy in infants born prematurely to women without preeclampsia.
We conducted a retrospective case-control study of infants with birth weights <1500 g and of infants with birth weights from 1500 to 1999 g who were born at <33 weeks' gestation. The study infants were born in level 2 or level 3 hospitals from 1988 through 1994 to women without preeclampsia, were delivered >3 hours after admission, and had survived to age 2 years.
Among 170 children with cerebral palsy and 288 control subjects, similar proportions of case mothers (58%) and control mothers (62%) had received magnesium sulfate tocolysis. In women with some tocolytic treatment, these proportions were 78% and 76%, respectively. The duration of treatment with magnesium was comparable for case and control women, as were the intervals from beginning and termination of treatment to delivery. Adjustment for gestational age, birth weight, and other variables did not alter this result.
Magnesium exposure was not associated with a lower risk of cerebral palsy in infants born prematurely to women without preeclampsia. The difference between this finding and that in our previous study showing an apparent neuroprotective effect of magnesium is not explained by the more restrictive selection criteria used here and may be related to a number of changes in medical practice between the 2 periods.
我们的目的是研究硫酸镁用于未患先兆子痫的早产孕妇的保胎治疗与婴儿脑瘫之间的关系。
我们对出生体重<1500克的婴儿以及出生体重在1500至1999克之间、孕龄<33周出生的婴儿进行了一项回顾性病例对照研究。研究对象为1988年至1994年在二级或三级医院出生的、母亲未患先兆子痫、入院后3小时以上分娩且存活至2岁的婴儿。
在170例脑瘫患儿和288例对照对象中，病例组母亲（58%）和对照组母亲（62%）接受硫酸镁保胎治疗的比例相似。在接受了某种保胎治疗的女性中，这一比例分别为78%和76%。病例组和对照组女性使用硫酸镁治疗的持续时间相当，从开始治疗到结束治疗再到分娩的间隔时间也相当。对孕龄、出生体重和其他变量进行调整后，这一结果并未改变。
对于未患先兆子痫的早产孕妇，婴儿接触硫酸镁与患脑瘫风险降低并无关联。本研究结果与我们之前显示硫酸镁具有明显神经保护作用的研究结果存在差异，这并非由本研究中更严格的选择标准所解释，可能与这两个时期医疗实践中的一些变化有关。
