Gursoy Tugba, Imamoglu Ebru Yalin, Ovali Fahri, Karatekin Guner
Neonatal Intensive Care Unit, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey.
Neonatal Intensive Care Unit, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey.
Am J Perinatol. 2015 Sep;32(11):1064-9. doi: 10.1055/s-0035-1548541. Epub 2015 Mar 31.
This study aims to investigate the effects of antenatal magnesium sulfate on intestinal blood flow in preterm neonates.
In this prospective case-match study, 25 preterm neonates exposed to magnesium sulfate antenatally were included (study group). Overall, 25 gestational age-matched neonates who had no exposure to magnesium constituted the control group. Serial daily Doppler flow measurements of superior mesenteric artery (SMA) were performed. The time to reach full feeds, first meconium passage were assessed. Presence of feeding intolerance or necrotizing enterocolitis was recorded.
Blood flow velocities of SMA were not different between the groups during the first five postnatal days. However, SMA blood flow showed an increasing trend in the control group unlike the study group (control group, p < 0.001; study group, p = 0.29). There was no significant difference between the two groups regarding the time to reach full feeds or first meconium passage and presence of feeding intolerance. No case of necrotizing enterocolitis was seen.
Antenatal magnesium does not significantly affect intestinal blood flow, but it seems to attenuate the increasing trend of the intestinal blood flow in the early postnatal days. However, this study failed to show any impact of this finding on clinical outcomes.
本研究旨在探讨产前硫酸镁对早产儿肠道血流的影响。
在这项前瞻性病例对照研究中,纳入了25例产前暴露于硫酸镁的早产儿(研究组)。总体而言,25例胎龄匹配且未暴露于硫酸镁的新生儿构成对照组。对肠系膜上动脉(SMA)进行每日连续多普勒血流测量。评估达到全量喂养的时间、首次排胎便的情况。记录喂养不耐受或坏死性小肠结肠炎的发生情况。
出生后前五天,两组间SMA血流速度无差异。然而,与研究组不同,对照组SMA血流呈上升趋势(对照组,p<0.001;研究组,p = 0.29)。两组在达到全量喂养的时间、首次排胎便情况以及喂养不耐受的发生方面无显著差异。未观察到坏死性小肠结肠炎病例。
产前使用镁剂不会显著影响肠道血流,但似乎会减弱出生后早期肠道血流的上升趋势。然而,本研究未能显示这一发现对临床结局有任何影响。