Nelson K B, Grether J K
Neuroepidemiology Branch, National Institutes of Neurological Disorders and Stroke, Bethesda, MD.
Pediatrics. 1995 Feb;95(2):263-9.
To investigate whether in utero exposure to magnesium sulfate (MgSO4) was associated with a lower prevalence of cerebral palsy (CP) in infants born weighing < 1500 g.
Singleton infants weighing < 1500 g at birth (very low birthweight, VLBW) and surviving to 3 years with moderate or severe congenital CP were identified among 155,636 children born 1983 through 1985 in four California counties. VLBW children with CP were compared with randomly selected VLBW control survivors with respect to whether their mothers received MgSO4 to prevent convulsions in preeclampsia or as a tocolytic agent, and other information abstracted from labor and delivery records.
During the admission for delivery, 7.1% of the 42 VLBW infants with later CP and 36% of the 75 VLBW controls were exposed to MgSO4 (odds ratio (OR) .14, 95% confidence interval (CI) .05, .51). The overall association of MgSO4 with reduced risk of CP was also observed in the subgroup of infants born to women who were not preeclamptic (OR .25, CI .08, .97). Infants with CP were less often exposed antenatally to MgSO4 whether or not there was cotreatment with non-MgSO4 tocolytics (other tocolytics administered, OR for MgSO4 exposure .23, CI .06, 1.2; other tocolytics not administered, OR for MgSO4 .08, CI .02, .68), or antenatal corticosteroids (steroids given, OR for MgSO4 exposure .24, CI .06, 1.3; steroids not given, OR for MgSO4, .08, CI .02, .72). Apparent benefit of magnesium was observed in the presence or absence of a variety of characteristics of pregnancies, births, and infants.
In this observational study, in utero exposure to MgSO4 was more frequent in controls than in children with CP, suggesting a protective effect of MgSO4 against CP in these VLBW infants.
探讨宫内暴露于硫酸镁（MgSO4）是否与出生体重<1500g的婴儿脑瘫（CP）患病率较低相关。
在加利福尼亚州四个县1983年至1985年出生的155,636名儿童中，确定出生体重<1500g（极低出生体重，VLBW）且存活至3岁患有中度或重度先天性CP的单胎婴儿。将患有CP的VLBW儿童与随机选择的VLBW对照存活者进行比较，比较他们的母亲是否接受MgSO4以预防先兆子痫中的惊厥或作为宫缩抑制剂，以及从分娩记录中提取的其他信息。
在分娩入院期间，42名后来患有CP的VLBW婴儿中有7.1%以及75名VLBW对照中有36%暴露于MgSO4（比值比（OR）0.14，95%置信区间（CI）0.05，0.51）。在未患先兆子痫的女性所生婴儿亚组中也观察到MgSO4与CP风险降低之间的总体关联（OR 0.25，CI 0.08，0.97）。无论是否与非MgSO4宫缩抑制剂联合治疗（给予其他宫缩抑制剂，MgSO4暴露的OR为0.23，CI 0.06，1.2；未给予其他宫缩抑制剂，MgSO4的OR为0.08，CI 0.02，0.68），或者产前是否使用糖皮质激素（给予糖皮质激素，MgSO4暴露的OR为0.24，CI 0.06，1.3；未给予糖皮质激素，MgSO4的OR为0.08，CI 0.02，0.72），患有CP的婴儿产前较少暴露于MgSO4。在存在或不存在各种妊娠、分娩和婴儿特征的情况下均观察到镁的明显益处。
在这项观察性研究中，对照组中宫内暴露于MgSO4的情况比患有CP的儿童更频繁，提示MgSO4对这些VLBW婴儿的CP有保护作用。
