Can magnesium sulfate reduce the risk of cerebral palsy in very low birthweight infants?
Can magnesium sulfate reduce the risk of cerebral palsy in very low birthweight infants?
复制标题
硫酸镁可以降低极低出生体重婴儿脑瘫的风险吗？
DOI：
10.1097/00006254-199508000-00004
复制
发表时间：
1995
期刊：
影响因子：
8
通讯作者：
J. Grether
中科院分区：
文献类型：
--
作者：
K. Nelson;J. Grether
目标
旨在调查子宫内暴露于硫酸镁 (MgSO4) 是否与出生体重 < 1500 g 的婴儿脑瘫 (CP) 患病率较低相关。
设计
在加州四个县 1983 年至 1985 年出生的 155,636 名儿童中，发现了出生时体重 < 1500 克（极低出生体重，VLBW）且存活至 3 岁且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 对照幸存者进行比较，比较他们的母亲是否接受 MgSO4 来预防先兆子痫惊厥或作为宫缩剂，以及从分娩和分娩记录中提取的其他信息。
结果
在入院分娩期间，42 名晚期 CP 的 VLBW 婴儿中的 7.1% 和 75 名 VLBW 对照中的 36% 暴露于 MgSO4（比值比 (OR) 0.14，95% 置信区间 (CI) 0.05，0.51）。在非先兆子痫女性所生婴儿亚组中也观察到 MgSO4 与 CP 风险降低的总体关联（OR .25，CI .08，.97）。无论是否使用非 MgSO4 宫缩药物（施用其他宫缩药物，或 MgSO4 暴露，OR 0.23，CI 0.06，1.2；未施用其他宫缩药物，OR MgSO4 0.08，CI 0.02，0.68）或产前皮质类固醇，患有 CP 的婴儿在产前接触 MgSO4 的情况较少 （给予类固醇，MgSO4 暴露的 OR 0.24，CI 0.06，1.3；未给予类固醇，MgSO4 的 OR，0.08，CI 0.02，0.72）。在怀孕、分娩和婴儿的各种特征存在或不存在的情况下观察到镁的明显益处。
结论
在这项观察性研究中，对照组在子宫内接触 MgSO4 的频率高于 CP 儿童，这表明 MgSO4 对这些 VLBW 婴儿的 CP 具有保护作用。
OBJECTIVES
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.
DESIGN
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.
RESULTS
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.
CONCLUSION
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.