产前硫酸镁用于预防孕周小于34周早产儿脑瘫：一项系统评价和荟萃分析。
Antenatal magnesium sulfate for the prevention of cerebral palsy in preterm infants less than 34 weeks' gestation: a systematic review and metaanalysis.
作者信息
Conde-Agudelo Agustín, Romero Roberto
机构信息
Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
出版信息
Am J Obstet Gynecol. 2009 Jun;200(6):595-609. doi: 10.1016/j.ajog.2009.04.005.
Abstract
We conducted a systematic review and metaanalysis of randomized controlled trials to determine whether magnesium sulfate administered to women at risk of preterm delivery before 34 weeks of gestation may reduce the risk of cerebral palsy in their children. Six trials involving 4796 women and 5357 infants were included. Antenatal magnesium sulfate was associated with a significant reduction in the risk of cerebral palsy (relative risk [RR], 0.69; 95% confidence interval [CI], 0.55-0.88), moderate or severe cerebral palsy (RR, 0.64; 95% CI, 0.44-0.92), and substantial gross motor dysfunction (RR, 0.60; 95% CI, 0.43-0.83). There was no overall difference in the risk of total pediatric mortality (RR, 1.01; 95% CI, 0.89-1.14). Minor side effects were more frequent among women receiving magnesium sulfate. In conclusion, magnesium sulfate administered to women at risk of delivery before 34 weeks of gestation reduces the risk of cerebral palsy.
摘要
我们进行了一项随机对照试验的系统评价和荟萃分析，以确定在妊娠34周前对有早产风险的妇女使用硫酸镁是否可降低其子女患脑瘫的风险。纳入了六项涉及4796名妇女和5357名婴儿的试验。产前使用硫酸镁与脑瘫风险显著降低相关（相对风险[RR]，0.69；95%置信区间[CI]，0.55 - 0.88），中重度脑瘫风险降低（RR，0.64；95%CI，0.44 - 0.92），以及严重粗大运动功能障碍风险降低（RR，0.60；95%CI，0.43 - 0.83）。儿童总死亡率风险无总体差异（RR，1.01；95%CI，0.89 - 1.14）。接受硫酸镁治疗的妇女中轻微副作用更常见。总之，在妊娠34周前对有分娩风险的妇女使用硫酸镁可降低脑瘫风险。
相似文献
1
Antenatal magnesium sulfate for the prevention of cerebral palsy in preterm infants less than 34 weeks' gestation: a systematic review and metaanalysis.产前硫酸镁用于预防孕周小于34周早产儿脑瘫：一项系统评价和荟萃分析。
Am J Obstet Gynecol. 2009 Jun;200(6):595-609. doi: 10.1016/j.ajog.2009.04.005.
2
Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews.预防脑瘫的产前和产时干预措施：Cochrane系统评价概述
Cochrane Database Syst Rev. 2017 Aug 8;8(8):CD012077. doi: 10.1002/14651858.CD012077.pub2.
3
Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus.硫酸镁用于有早产风险的妇女以保护胎儿神经。
Cochrane Database Syst Rev. 2009 Jan 21(1):CD004661. doi: 10.1002/14651858.CD004661.pub3.
4
Antenatal magnesium sulfate and neurologic outcome in preterm infants: a systematic review.产前硫酸镁与早产儿神经学结局：一项系统评价
Obstet Gynecol. 2009 Jun;113(6):1327-1333. doi: 10.1097/AOG.0b013e3181a60495.
5
Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus.硫酸镁用于有早产风险的女性以保护胎儿神经。
Cochrane Database Syst Rev. 2007 Jul 18(3):CD004661. doi: 10.1002/14651858.CD004661.pub2.
6
Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.孕激素产前给药预防多胎妊娠妇女自发性早产。
Cochrane Database Syst Rev. 2019 Nov 20;2019(11):CD012024. doi: 10.1002/14651858.CD012024.pub3.
7
Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.孕激素产前给药预防多胎妊娠妇女自发性早产。
Cochrane Database Syst Rev. 2017 Oct 31;10(10):CD012024. doi: 10.1002/14651858.CD012024.pub2.
8
Effects of targeting lower versus higher arterial oxygen saturations on death or disability in preterm infants.针对较低与较高动脉血氧饱和度对早产儿死亡或残疾的影响。
Cochrane Database Syst Rev. 2017 Apr 11;4(4):CD011190. doi: 10.1002/14651858.CD011190.pub2.
9
Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth.不同的皮质类固醇药物和方案用于加速有早产风险的婴儿的胎儿肺成熟。
Cochrane Database Syst Rev. 2022 Aug 9;8(8):CD006764. doi: 10.1002/14651858.CD006764.pub4.
10
Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome.对于妊娠37周前胎膜早破的孕妇，计划早产与期待治疗以改善妊娠结局的比较。
Cochrane Database Syst Rev. 2017 Mar 3;3(3):CD004735. doi: 10.1002/14651858.CD004735.pub4.
引用本文的文献
1
Clinical guidance VVOG: Antenatal care for twin pregnancies.临床指南VVOG：双胎妊娠的产前护理
Eur J Obstet Gynecol Reprod Biol X. 2025 Jun 27;27:100414. doi: 10.1016/j.eurox.2025.100414. eCollection 2025 Sep.
2
Antenatal Low Dose Magnesium Sulphate for Foetal Neuroprotection in Preterm Birth Versus Control: A Comparative Prospective Cohort Study in Tertiary Care Centre in India.印度三级护理中心开展的一项比较性前瞻性队列研究：产前低剂量硫酸镁用于早产胎儿神经保护与对照的比较
J Obstet Gynaecol India. 2025 Feb;75(1):46-52. doi: 10.1007/s13224-023-01902-4. Epub 2023 Dec 2.
3
Current Approaches and Innovations in Managing Preeclampsia: Highlighting Maternal Health Disparities.子痫前期管理的当前方法与创新：凸显孕产妇健康差异
J Clin Med. 2025 Feb 11;14(4):1190. doi: 10.3390/jcm14041190.
4
Magnesium sulfate for fetal neuroprotection in preterm pregnancy: a meta-analysis of randomized controlled trials.硫酸镁在早产胎儿神经保护中的应用：一项随机对照试验的荟萃分析。
BMC Pregnancy Childbirth. 2024 Aug 1;24(1):519. doi: 10.1186/s12884-024-06703-9.
5
Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus.硫酸镁用于有早产风险的妇女，以保护胎儿的神经。
Cochrane Database Syst Rev. 2024 May 10;5(5):CD004661. doi: 10.1002/14651858.CD004661.pub4.
6
Clinical application of amino-terminal pro-brain natriuretic peptide concentration in amniotic fluid for the prediction of preterm birth in symptomatic women.羊水氨基末端脑钠肽前体浓度在有症状孕妇早产预测中的临床应用
AJOG Glob Rep. 2024 Mar 30;4(2):100345. doi: 10.1016/j.xagr.2024.100345. eCollection 2024 May.
7
Magnesium sulfate and risk of hypoxic-ischemic encephalopathy in a high-risk cohort.硫酸镁与高危队列中缺氧缺血性脑病的风险。
Am J Obstet Gynecol. 2024 Dec;231(6):647.e1-647.e12. doi: 10.1016/j.ajog.2024.04.001. Epub 2024 Apr 3.
8
Accuracy of prenatal and postnatal biomarkers for estimating gestational age: a systematic review and meta-analysis.用于估计胎龄的产前和产后生物标志物的准确性：一项系统评价和荟萃分析。
EClinicalMedicine. 2024 Mar 8;70:102498. doi: 10.1016/j.eclinm.2024.102498. eCollection 2024 Apr.
9
Antenatal Magnesium Sulfate Is Not Associated With Improved Long-Term Neurodevelopment and Growth in Very Low Birth Weight Infants.产前硫酸镁治疗与极低出生体重儿的长期神经发育和生长改善无关。
J Korean Med Sci. 2023 Nov 13;38(44):e350. doi: 10.3346/jkms.2023.38.e350.
10
Declining incidence of cerebral palsy in South Korea.韩国脑瘫发病率下降。
Sci Rep. 2023 Jun 28;13(1):10496. doi: 10.1038/s41598-023-36236-8.
本文引用的文献
1
Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus.硫酸镁用于有早产风险的妇女以保护胎儿神经。
Cochrane Database Syst Rev. 2009 Jan 21(1):CD004661. doi: 10.1002/14651858.CD004661.pub3.
2
Establishing the diagnosis of cerebral palsy.脑瘫的诊断确立。
Clin Obstet Gynecol. 2008 Dec;51(4):742-8. doi: 10.1097/GRF.0b013e318187081a.
3
Changes in erythrocyte glutathione and plasma membrane calcium pump in preterm newborns treated antenatally with MgSO4.产前接受硫酸镁治疗的早产儿红细胞谷胱甘肽和质膜钙泵的变化。
Neonatology. 2008;94(4):272-8. doi: 10.1159/000151646. Epub 2008 Sep 11.
4
A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy.硫酸镁预防脑瘫的随机对照试验。
N Engl J Med. 2008 Aug 28;359(9):895-905. doi: 10.1056/NEJMoa0801187.
5
Long-term medical and social consequences of preterm birth.早产的长期医学和社会后果。
N Engl J Med. 2008 Jul 17;359(3):262-73. doi: 10.1056/NEJMoa0706475.
6
Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review.脑瘫的患病率、类型、分布及严重程度与孕周的关系：一项荟萃分析综述
Dev Med Child Neurol. 2008 May;50(5):334-40. doi: 10.1111/j.1469-8749.2008.02047.x. Epub 2008 Mar 18.
7
Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multisite collaboration.2002年美国三个地区8岁儿童脑瘫患病率：一项多地点合作研究
Pediatrics. 2008 Mar;121(3):547-54. doi: 10.1542/peds.2007-1270.
8
Benefit of magnesium sulfate given before very preterm birth to protect infant brain.极早产前给予硫酸镁对保护婴儿大脑的益处。
Pediatrics. 2008 Jan;121(1):225-6. doi: 10.1542/peds.2007-2971.
9
A cost decision analysis of 4 tocolytic drugs.四种宫缩抑制剂药物的成本决策分析
Am J Obstet Gynecol. 2007 Oct;197(4):383.e1-6. doi: 10.1016/j.ajog.2007.06.052.
10
Does peripartum infection increase the incidence of cerebral palsy in extremely low birthweight infants?围产期感染会增加极低出生体重儿患脑瘫的发生率吗？
Am J Obstet Gynecol. 2007 May;196(5):e6-8. doi: 10.1016/j.ajog.2007.01.009.
Zotero 插件