Antenatal Magnesium Sulfate, Necrotizing Enterocolitis, and Death among Neonates < 28 Weeks Gestation.
Antenatal Magnesium Sulfate, Necrotizing Enterocolitis, and Death among Neonates < 28 Weeks Gestation.
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DOI：
10.1055/s-0036-1581059
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发表时间：
2016-03
期刊：
影响因子：
0.9
通讯作者：
Manuck TA
中科院分区：
文献类型：
--
作者：
Kamyar M;Clark EA;Yoder BA;Varner MW;Manuck TA
目的探讨产前硫酸镁（MgSO 4）与新生儿死亡和（或）28周以内严重坏死性小肠结肠炎（NEC）的关系。 方法对一项多中心随机试验进行二次分析，该试验比较了产前给予MgSO 4与安慰剂对妇女预防死亡和脑瘫的作用。 包括< 28周的新生儿。主要结局为NICU出院前新生儿死亡和/或重度NEC（Bell标准II/III期）。比较有和无死亡/重度NEC的新生儿。 结果697例新生儿符合诊断标准。 其中150例（21.5%）死亡和/或诊断为重度NEC。出生后MgSO 4暴露与< 28周婴儿的死亡/严重NEC无关。在< 26周新生儿的亚组分析中，产前MgSO 4治疗组分配与死亡/重度NEC的几率增加相关（调整后的比值比：1.90，95%置信区间：1.12-3.22，p = 0.017）。 结论在< 26周的新生儿中，产前硫酸镁与死亡和严重NEC有关。 需要在更大的人群中进行进一步的前瞻性研究。
Objective This study aims to examine the relationship between antenatal magnesium sulfate (MgSO4) and neonatal death and/or severe necrotizing enterocolitis (NEC) among infants < 28 weeks. Methods Secondary analysis of a multicenter randomized trial of antenatal MgSO4 versus placebo administered to women to prevent death and cerebral palsy. Neonates < 28 weeks were included. The primary outcome was neonatal death before NICU discharge, and/or severe NEC (Bell criteria stage II/III). Neonates with and without death/severe NEC were compared. Results A total of 697 neonates met the criteria. Out of which 150 (21.5%) died and/or were diagnosed with severe NEC. Antenatal MgSO4 exposure was not associated with death/severe NEC in infants < 28 weeks. In a subgroup analysis of neonates < 26 weeks, treatment group assignment to antenatal MgSO4 was associated with an increased odds of death/severe NEC (adjusted odds ratio: 1.90, 95% confidence interval: 1.12–3.22, p = 0.017). Conclusions Among neonates < 26 weeks, antenatal MgSO4 was associated with death and severe NEC. Further prospective study in larger populations is needed.