Department of Maternal-Fetal Medicine, Duke University Hospital, Durham, North Carolina.
Department of Maternal Fetal Medicine, WakeMed Health and Hospitals, Raleigh, North Carolina.
Am J Perinatol. 2019 Jan;36(1):3-7. doi: 10.1055/s-0038-1627097. Epub 2018 Feb 12.
We examined the effects of magnesium sulfate on non-neurologic neonatal outcomes with respect to cord blood magnesium level.
We conducted a secondary analysis of the Maternal-Fetal Medicine Units Beneficial Effects of Antenatal Magnesium (MFMU BEAM) trial comparing the upper and lower quintiles of cord blood magnesium level. Outcomes included cerebral palsy (CP), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and assessments of mental and motor disability. Logistic regression was used to estimate adjusted odds ratios (aORs) of each outcome, controlling for gestational age (GA), birth weight, and treatment group (TG).
A total of 1,254 women of the 2,444 included in the BEAM trial had cord blood magnesium levels recorded. GA and birth weight were lower and TG was more common in the upper quintile cohort ( < 0.001). Neonates in the upper quintile were more likely to have severe NEC (OR, 2.41, 95% confidence interval [CI]: 1.11-5.24), ROP (OR, 1.65, 95% CI: 1.05-2.59), and BPD (OR, 1.70, 95% CI: 1.04-2.73). Adjustment for covariates demonstrated no difference in the NEC, ROP, and BPD rates, although there was a decrease in rates of mental disability index < 70 which was not seen in the unadjusted analysis (aOR, 0.49, 95% CI: 0.25-0.99).
Higher cord blood magnesium levels do not appear to have adverse non-neurologic effects on the neonate and may demonstrate improvement in neurologic outcomes.
我们研究了脐带血镁水平与非神经新生儿结局的关系。
我们对 Maternal-Fetal Medicine Units Beneficial Effects of Antenatal Magnesium (MFMU BEAM) 试验进行了二次分析，比较了脐带血镁水平的上五分位数和下五分位数。结局包括脑瘫（CP）、坏死性小肠结肠炎（NEC）、早产儿视网膜病变（ROP）、支气管肺发育不良（BPD），以及精神和运动障碍的评估。使用逻辑回归估计每个结局的调整后比值比（aOR），控制胎龄（GA）、出生体重和治疗组（TG）。
在 BEAM 试验中，共有 2444 名产妇中的 1254 名产妇的脐带血镁水平得到了记录。上五分位数队列的 GA 和出生体重较低，TG 更为常见（<0.001）。上五分位数组的新生儿更有可能患有严重 NEC（OR，2.41，95%置信区间[CI]：1.11-5.24）、ROP（OR，1.65，95% CI：1.05-2.59）和 BPD（OR，1.70，95% CI：1.04-2.73）。调整协变量后，NEC、ROP 和 BPD 的发生率没有差异，尽管精神残疾指数<70 的发生率有所下降，而未调整分析中未见此现象（aOR，0.49，95% CI：0.25-0.99）。
脐带血镁水平升高似乎不会对新生儿产生不良的非神经影响，并且可能对神经结局有改善作用。
