Rattray B N, Kraus D M, Drinker L R, Goldberg R N, Tanaka D T, Cotten C M
Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Department of Maternal-Fetal Medicine/Obstetrics, Duke University Medical Center, Durham, NC, USA.
J Perinatol. 2014 Nov;34(11):819-22. doi: 10.1038/jp.2014.106. Epub 2014 Jun 5.
Evaluate spontaneous intestinal perforation (SIP)/death among extremely low birthweight (ELBW) infants before, during and after initiation of an antenatal magnesium for neuroprotection protocol (MgPro).
We tested associations between SIP/death and magnesium exposure, gestational age (GA) and interactions with GA and magnesium exposure in a cohort of inborn ELBW infants before, during and after MgPro.
One hundred and fifty-five ELBW infants were included, 81 before, 23 during and 51 after MgPro. ELBW infants (78.3%) were exposed to Mg during MgPro compared with 50.6% and 60.8% before and after, respectively. Incidence of SIP on protocol was 30.4% vs 12.9% off protocol (P=0.03). GA was strongly associated with SIP (P<0.01). Antenatal Mg dose was also associated with SIP/death regardless of epoch (odds ratio 9.3 (1.04-104.6)), but increased SIP/death was limited to those <25 weeks gestation.
Higher Mg dose was associated with higher SIP and death risk among infants with the lowest birthweights. Validation of this observation in larger populations is warranted.
评估在启动产前镁剂神经保护方案（MgPro）之前、期间和之后极低出生体重（ELBW）婴儿的自发性肠穿孔（SIP）/死亡情况。
我们在一组出生时为ELBW的婴儿中，测试了MgPro之前、期间和之后SIP/死亡与镁暴露、胎龄（GA）以及GA与镁暴露之间的相互作用。
纳入了155例ELBW婴儿，MgPro之前81例，期间23例，之后51例。与MgPro之前（50.6%）和之后（60.8%）相比，MgPro期间有78.3%的ELBW婴儿暴露于镁剂。方案期间SIP的发生率为30.4%，方案外为12.9%（P = 0.03）。GA与SIP密切相关（P < 0.01）。无论处于哪个时期，产前镁剂剂量也与SIP/死亡相关（比值比9.3（1.04 - 104.6）），但SIP/死亡的增加仅限于妊娠<25周的婴儿。
出生体重最低的婴儿中，较高的镁剂剂量与较高的SIP和死亡风险相关。有必要在更大规模人群中验证这一观察结果。
