title: Association between maternal serum ionized magnesium levels at delivery and neonatal intraventricular hemorrhage.
abstract: OBJECTIVE
  To determine whether magnesium sulfate (MgSO(4)) exposure is associated with a reduced risk for neonatal intraventricular hemorrhage (IVH).
  
  
  METHODS
  In a randomized, controlled trial, women in preterm labor were randomly assigned to receive MgSO(4), "other" tocolytic, or saline control. At delivery, we collected maternal antecubital and umbilical cord blood for determination of serum ionized magnesium levels. Neonatal IVH was diagnosed by cranial ultrasonogram.
  
  
  RESULTS
  Among 144 infants, 24 were diagnosed with IVH. Using crude intention-to-treat analysis, we found that 18% (13/74) of survivors exposed after birth to MgSO(4) had IVH compared with 16% (11/70) of babies who were not exposed. Infants who had IVH were more likely to have been delivered by mothers with higher serum ionized magnesium (Mg) levels (0.75 vs 0.56 mmol/L) (P =.01). Using multivariable logistic regression, we confirmed that higher Mg levels are a significant predictor of neonatal IVH (adjusted odds ratio, 15.8; 95% CI, 1.4-175.0) even when adjusted for birth weight, gestational age, antenatal hemorrhage, and neonatal glucocorticoid exposure.
  
  
  CONCLUSIONS
  In mothers with preterm labor, our data indicate that antenatal MgSO(4) exposure may be associated with an increased risk for IVH among their newborns.
authors.affiliation: Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Mittendorf
authors.forename: James
authors.initials: J
authors.lastname: Dambrosia
authors.forename: Olaf
authors.initials: O
authors.lastname: Dammann
authors.forename: Peter G
authors.initials: PG
authors.lastname: Pryde
authors.forename: Kwang-Sun
authors.initials: KS
authors.lastname: Lee
authors.forename: Tamar E
authors.initials: TE
authors.lastname: Ben-Ami
authors.forename: David
authors.initials: D
authors.lastname: Yousefzadeh
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000097:blood; D015999:Multivariate Analysis; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012306:Risk; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000097:blood; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology
chemical_list: D015149:Tocolytic Agents; D008278:Magnesium Sulfate