Neuroprotective effect of magnesium sulfate in premature infants. Analysis after establishing an antenatal administration protocol in a tertiary care hospital

• Published in: Anales de Pediatría 2023-10, Vol.99 (4), p.224-231
• Main Authors: Fernández Monteagudo, Belén, Villar Castro, Sonia, Carrascosa García, Paula, Zeballos Sarrato, Susana, Sánchez Luna, Manuel
• Format: Article
• Language: English
• Subjects: Cerebral palsy; Cognitive deficit; Déficit cognitivo; Enterocolitis necrotizante; Mortalidad; Mortality; Necrotizing enterocolitis; Parálisis cerebral infantil; Prematuridad; Prematurity
• ISSN: 2341-2879; 2341-2879
• DOI: 10.1016/j.anpede.2023.07.007

[Display omitted] In 2016, a protocol was developed in our hospital for the antenatal administration of magnesium sulfate in pregnant women at risk of imminent preterm birth as a method to reduce the risk of cerebral palsy (CP). We conducted a retrospective observational study in a level IIIC hospital with the primary objective of comparing the incidence of CP before and after the implementation of this protocol. Among the secondary outcomes, we ought to highlight the incidence of cognitive deficits and necrotizing enterocolitis and the mortality in both groups. The sample consisted of preterm newborns delivered before 32 weeks of gestation in 2011−2012 (prior to the implementation of the protocol) and in 2016−2018 (after the implementation of the protocol, whose mothers had received magnesium sulfate for neuroprotection). The clinical and epidemiological characteristics of both groups were comparable. We collected data for a total of 523 patients, 263 and 260 in each group. As regards the primary outcome, we did not find statistically significant differences between groups. We observed a statistically significant reduction in mortality and the risk of severe necrotizing enterocolitis in the group of patients born in the 2016−2018 period and between 26+0 and 27+6 weeks of gestation, whose mothers had received magnesium sulfate. In our study, the administration of magnesium sulfate to mothers at risk of preterm birth did not decrease the risk of developing CP. En 2016 se desarrolló en nuestro centro un protocolo de administración antenatal de sulfato de magnesio en gestantes con riesgo de parto pretérmino inminente como método para disminuir el riesgo de parálisis cerebral (PC). Se realizó un estudio observacional y retrospectivo en un hospital de Nivel IIIC con objetivo principal de comparar la incidencia de PC previa y posteriormente a la puesta en marcha de este protocolo. Con respecto a los objetivos secundarios, a destacar la incidencia de déficit cognitivo, enterocolitis necrotizante y mortalidad en ambos grupos. Los pacientes incluidos fueron recién nacidos prematuros por debajo de 32 semanas de edad gestacional nacidos en los años 2011−2012 (previo a la instauración del protocolo) y 2016−2018 (posteriormente a la instauración del protocolo, cuyas madres habían recibido sulfato de magnesio como neuroprotector). Las características clínicas y epidemiológicas de ambos grupos fueron comparables entre sí. Se recogieron datos de un total de 523 pacientes,