Antenatal Magnesium and Cerebral Palsy in Preterm Infants

Deborah G. Hirtz, Steven J. Weiner, Dorothy Bulas, Michael DiPietro, Joanna Seibert, Dwight J. Rouse, Brian M. Mercer, Michael W. Varner, Uma M. Reddy, Jay D. Iams, Ronald J. Wapner, Yoram Sorokin, John M. Thorp, Susan M. Ramin, Fergal D. Malone, Marshall W. Carpenter, Mary J. O'Sullivan, Alan M. Peaceman, Gary D V Hankins, Donald DudleySteve N. Caritis

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objective: To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design: In a randomized trial of MgSO4 or placebo in women at high risk of preterm delivery, up to 3 cranial ultrasounds were obtained in the neonatal period. Images were reviewed by at least 2 pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at 2years of age by standardized neurologic examination. Results: Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 administration did not affect the risk of cranial ultrasound abnormality observed at 35weeks postmenstrual age or later. However, for the 82% of infants born at 4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (P=.04), and for echodensity explained 20% of the effect (P=.02). Conclusions: MgSO4 given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at 4 on CP at 2years of age. Trial Registration: ClinicalTrials.gov: NCT00014989.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StateAccepted/In press - Nov 4 2014
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Hirtz, D. G., Weiner, S. J., Bulas, D., DiPietro, M., Seibert, J., Rouse, D. J., Mercer, B. M., Varner, M. W., Reddy, U. M., Iams, J. D., Wapner, R. J., Sorokin, Y., Thorp, J. M., Ramin, S. M., Malone, F. D., Carpenter, M. W., O'Sullivan, M. J., Peaceman, A. M., Hankins, G. D. V., ... Caritis, S. N. (Accepted/In press). Antenatal Magnesium and Cerebral Palsy in Preterm Infants. Journal of Pediatrics. https://doi.org/10.1016/j.jpeds.2015.06.067