Abstract
Antenatal magnesium sulfate (MgSO4) treatment is widely used for fetal neuroprotection in women at risk of preterm delivery. However, some studies have recently suggested that in utero MgSO4 exposure is associated with an increased risk of necrotizing enterocolitis (NEC). This study aimed to investigate the association between antenatal MgSO4 treatment and risk of NEC. This retrospective cohort study included 756 infants born at 24–31 weeks’ gestation. Subjects were classified into three groups: period 1, when MgSO4 treatment protocol for fetal neuroprotection was not adopted (n = 267); period 2, when the protocol was adopted (n = 261); and period 3, when the protocol was withdrawn because of concern of risk of NEC (n = 228). Rates of NEC (≥ stage 2b) were analyzed according to time period and exposure to antenatal MgSO4. Significant difference in the rate of NEC was not found across the three time periods (2.6% vs. 6.5% vs. 4.8% in periods 1, 2 and 3, respectively, p = 0.103). The rate of NEC was comparable between the infants unexposed and exposed to antenatal MgSO4 (5.1% vs. 3.6%, p = 0.369). These results showed that antenatal MgSO4 treatment was not associated with risk of NEC in our study population.
Highlights
Antenatal magnesium sulfate (MgSO4) treatment is widely used for fetal neuroprotection in women at risk of preterm delivery
We investigated whether antenatal M gSO4 treatment per se or for fetal neuroprotection was associated with the risk of necrotizing enterocolitis (NEC) in preterm neonates at 24‒31 weeks of gestation
We investigated the effect of antenatal M gSO4 treatment on the risk of NEC by comparing neonatal outcomes before and after two major changes in the antenatal M gSO4 treatment protocol
Summary
Antenatal magnesium sulfate (MgSO4) treatment is widely used for fetal neuroprotection in women at risk of preterm delivery. The rate of NEC was comparable between the infants unexposed and exposed to antenatal MgSO4 (5.1% vs 3.6%, p = 0.369) These results showed that antenatal MgSO4 treatment was not associated with risk of NEC in our study population. Some studies have recently raised concerns about gastrointestinal effects of antenatal MgSO4 exposure on preterm neonates, including necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP)[11,12]. The objective of this study was to investigate whether these protocol changes might have any effect on the risk of NEC by comparing outcomes according to time periods classified by the adoption and withdrawal of antenatal M gSO4 treatment protocol for fetal neuroprotection. We investigated whether antenatal M gSO4 treatment per se or for fetal neuroprotection was associated with the risk of NEC in preterm neonates at 24‒31 weeks of gestation
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