Division of Neonatology, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA; The George Washington University, School of Medicine and Health Sciences, 2300 I Street NW, Washington, DC 20052, USA.
Pediatric Residency Program, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA.
Pediatr Neonatol. 2023 Nov;64(6):644-650. doi: 10.1016/j.pedneo.2022.10.008. Epub 2023 May 11.
Antenatal administration of magnesium sulfate (MgSO) to women in preterm labor has gained widespread use. This study examined the relationship between MgSO exposure with neonatal respiratory outcomes.
Very low birth weight (VLBW) infants exposed to antenatal MgSO were included. Infants who were intubated anytime during the first three days of life were compared to those who were not intubated regarding their demographic and clinical characteristics, MgSO therapy, immediate respiratory outcomes, and occurrence of intraventricular hemorrhage (IVH) using student t-test, chi square testing and logistic regression analysis to control for confounding variables. Correlation coefficient of MgSO cumulative dose given and duration of infusion with delivery room resuscitation and need for mechanical ventilation in the first 3 days of life were also calculated. Multilinear regression analysis was used to control for confounding factors.
Intubated group included 96 infants while non-intubated group included 171 infants. Although, intubated group has younger gestational age (26 vs. 29 weeks, p < 0.01) and lower birth weight (786 vs. 1115 g (g), p < 0.01), there were no significant differences between groups in regard to MgSO cumulative dose (24 vs. 27 g, p = 0.29), infusion time (14.6 vs. 18 h, p = 0.19) or infants' serum magnesium level (2.6 vs. 2.8 milliequivalents (mEq)/L p = 0.86). There was no correlation between cumulative MgSO4 dose with endotracheal intubation or cardiac resuscitation in the delivery room (cc: -0.03, p = 0.66; and 0.02, p = 0.79, respectively) or the need for mechanical ventilation in the first 3 days of life (cc: -0.04 to -0.07, p = 0.21-0.51). In addition, there was no relationship between MgSO dose, duration of infusion, or infant's serum magnesium level and occurrence of IVH.
Regardless of dose or duration of infusion, antenatal MgSO exposure is not associated with increased intubation or mechanical ventilation early in life.
在早产孕妇中使用产前硫酸镁（MgSO）已得到广泛应用。本研究旨在探讨 MgSO 暴露与新生儿呼吸结局之间的关系。
纳入接受产前 MgSO 治疗的极低出生体重（VLBW）婴儿。将出生后前 3 天内任何时间插管的婴儿与未插管的婴儿进行比较，比较其人口统计学和临床特征、MgSO 治疗、即刻呼吸结局以及使用学生 t 检验、卡方检验和 logistic 回归分析来控制混杂变量，比较是否发生颅内出血（IVH）。还计算了 MgSO 累积剂量与分娩室复苏以及出生后前 3 天机械通气需求的相关性。采用多元线性回归分析控制混杂因素。
插管组纳入 96 例婴儿，未插管组纳入 171 例婴儿。虽然插管组的胎龄（26 周 vs. 29 周，p < 0.01）和出生体重（786 克 vs. 1115 克，p < 0.01）更轻，但两组之间 MgSO 累积剂量（24 克 vs. 27 克，p = 0.29）、输注时间（14.6 小时 vs. 18 小时，p = 0.19）或婴儿血清镁水平（2.6 毫当量/升 vs. 2.8 毫当量/升，p = 0.86）均无显著差异。MgSO4 累积剂量与分娩室气管插管或心脏复苏（cc：-0.03，p = 0.66；和 0.02，p = 0.79）或出生后前 3 天机械通气需求（cc：-0.04 至-0.07，p = 0.21-0.51）之间无相关性。此外，MgSO 剂量、输注时间或婴儿血清镁水平与 IVH 的发生之间也没有关系。
无论剂量或输注时间如何，产前 MgSO 暴露与生命早期的插管或机械通气无关。
