First Department of Obstetrics and Gynecology, "Alexandra" General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Arch Gynecol Obstet. 2024 Mar;309(3):917-927. doi: 10.1007/s00404-023-07221-3. Epub 2023 Sep 28.
Magnesium sulfate (MgSO) has been widely used in obstetrics as a mean to help decrease maternal and neonatal morbidity in various antenatal pathology. As a factor, it seems to regulate immunity and can, thus, predispose to infectious morbidity. To date, it remains unknown if its administration can increase the risk of chorioamnionitis. In the present meta-analysis, we sought to accumulate the available evidence.
We systematically searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases in our primary search along with the reference lists of electronically retrieved full-text papers.
Eight studies were included that investigated the incidence of chorioamnionitis among parturient that received MgSO and control patients. Magnesium sulfate was administered in 3229 women and 3330 women served as controls as they did not receive MgSO. The meta-analysis of data revealed that there was no association between the administration of magnesium sulfate and the incidence of chorioamnionitis (OR 0.98, 95% CI 0.73, 1.32). Rucker's analysis revealed that small studies did not significantly influence the statistical significance of this finding (OR 1.12, 95% CI 0.82, 1.53). Trial sequential analysis revealed that the required number to safely interpret the primary outcome was not reached. Two studies evaluated the impact of MgSO in neonates delivered in the setting of chorioamnionitis. Neither of these indicated the presence of a beneficial effect in neonatal morbidity, including the risk of cerebral palsy, intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, stillbirth, or neonatal death.
Current evidence indicates that magnesium sulfate is not associated with an increased risk of maternal chorioamnionitis. However, it should be noted that its effect on neonatal outcomes of offspring born in the setting of chorioamnionitis might be subtle if any, although the available evidence is very limited.
硫酸镁（MgSO）已广泛用于产科，作为帮助降低各种产前病理产妇和新生儿发病率的手段。作为一种因素，它似乎调节免疫功能，因此可能导致感染发病率增加。迄今为止，尚不清楚其给药是否会增加绒毛膜羊膜炎的风险。在本荟萃分析中，我们试图积累现有证据。
我们在初步搜索中系统地搜索了 Medline、Scopus、Clinicaltrials.gov、EMBASE、Cochrane 中央对照试验注册中心（CENTRAL）和 Google Scholar 数据库，并检索了电子检索全文论文的参考文献列表。
共纳入 8 项研究，这些研究调查了接受硫酸镁和对照患者的产妇绒毛膜羊膜炎发生率。硫酸镁在 3229 名妇女中给药，3330 名妇女作为对照，因为她们没有接受硫酸镁。数据的荟萃分析显示，硫酸镁给药与绒毛膜羊膜炎的发生率之间没有关联（OR 0.98，95%CI 0.73，1.32）。Rucker 分析显示，小型研究并没有显著影响这一发现的统计学意义（OR 1.12，95%CI 0.82，1.53）。试验序贯分析显示，尚未达到安全解释主要结局所需的数量。有两项研究评估了 MgSO 在绒毛膜羊膜炎背景下分娩的新生儿的影响。这两项研究均未表明 MgSO 在新生儿发病率方面有任何有益影响，包括脑瘫、脑室内出血、坏死性小肠结肠炎、支气管肺发育不良、败血症、死产或新生儿死亡的风险。
目前的证据表明，硫酸镁与产妇绒毛膜羊膜炎的风险增加无关。然而，应该注意的是，其在绒毛膜羊膜炎背景下出生的新生儿的新生儿结局的影响可能是微妙的，如果有的话，尽管现有证据非常有限。
