School-Age Outcomes of Antenatal Magnesium Sulphate in Preterm Infants.

BACKGROUND

Antenatal magnesium sulphate (MgSO) therapy given to women at risk of preterm birth reduced the risk of cerebral palsy in early childhood. However, its effect on longer-term neurological outcomes remains uncertain. This study aimed to assess the effects of antenatal MgSO therapy on school-age outcomes of preterm infants.

METHODS

We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, CENTRAL, and CINAHL for randomized controlled trials (RCTs). Two reviewers independently evaluated the eligibility for inclusion and extracted data.

RESULTS

Ten RCTs were included. Only two of them were on school-age outcomes. Antenatal MgSO therapy had no impact on cerebral palsy, hearing impairment, neurosensory disability, and death at school-age. Meta-analysis on mental retardation and visual impairment was not able to be performed due to different methods of evaluation. In the analysis of short-term outcomes conducted as secondary outcomes, antenatal MgSO therapy increased the risk of maternal adverse events with any symptom (3 RCTs; risk ratio 2.79; 95% confidence interval 1.10 to 7.05, low certainty of evidence) but was not associated with any neonatal symptoms.

CONCLUSIONS

The number of cases was insufficient to determine the impact of antenatal MgSO therapy on school-age outcomes. Further accumulation of long-term data is required.