Association between the use of antenatal magnesium sulfate in preterm labor and adverse health outcomes in infants
Association between the use of antenatal magnesium sulfate in preterm labor and adverse health outcomes in infants
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DOI：
10.1067/mob.2002.123544
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发表时间：
2002-06-01
影响因子：
9.8
通讯作者：
Tomich, PG
中科院分区：
文献类型：
--
作者：
Mittendorf, R;Dambrosia, J;Tomich, PG
目的：本研究的目的是确定是否使用产前硫酸镁预防不良后果（新生儿脑室内出血，脑室周围白质软化症，死亡，脑性麻痹）。研究设计：在一项对照试验中，我们随机母亲在早产硫酸镁，“其他”保胎药，或安慰剂。在分娩时，收集脐带血用于随后测定血清离子镁水平。定期进行新生儿头颅超声扫描以诊断脑室内出血和脑室周围白质软化症。在幸存者中，脑瘫的诊断是在18个月的年龄。结果：有不良后果的儿童在分娩时脐带镁水平较高。在控制混杂因素（包括极低出生体重）的回归模型中，镁仍然是一个重要的风险因素（调整后的比值比，3.7; 95%CI，1.1-11.9; P= 0.03）。结论：与最初的假设相反，这项随机试验发现，产前使用硫酸镁与剂量反应方式的围产期结局相关，而不是更好。
OBJECTIVE: The purpose of this study was to determine whether the use of antenatal magnesium sulfate prevents adverse outcomes (neonatal intraventricular hemorrhage, periventricular leucomalacia, death, and cerebral palsy).STUDY DESIGN: In a controlled trial, we randomized mothers in preterm labor to magnesium sulfate, "other" tocolytic, or placebo. At delivery, umbilical cord blood was collected for the later determination of serum ionized magnesium levels. Neonatal cranial ultrasound scans were obtained periodically for the diagnosis of intraventricular hemorrhage and periventricular leucomalacia. Among survivors, the diagnosis of cerebral palsy was made at age 18 months.RESULTS: Children with adverse outcomes had higher umbilical cord magnesium levels at delivery. In regression models that controlled for confounders, which included very low birth weight, magnesium remained a significant risk factor (adjusted odds ratio, 3.7; 95% CI, 1.1-11.9; P=.03).CONCLUSION: Contrary to original hypotheses, this randomized trial found that the use of antenatal magnesium sulfate was associated with worse, not better, perinatal outcome in a dose-response fashion.