title: Association between the use of antenatal magnesium sulfate in preterm labor and adverse health outcomes in infants.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the use of antenatal magnesium sulfate prevents adverse outcomes (neonatal intraventricular hemorrhage, periventricular leucomalacia, death, and cerebral palsy).
  
  
  METHODS
  In a controlled trial, we randomized mothers in preterm labor to magnesium sulfate, "other" tocolytic, or placebo. At delivery, umbilical cord blood was collected for the later determination of serum ionized magnesium levels. Neonatal cranial ultrasound scans were obtained periodically for the diagnosis of intraventricular hemorrhage and periventricular leucomalacia. Among survivors, the diagnosis of cerebral palsy was made at age 18 months.
  
  
  RESULTS
  Children with adverse outcomes had higher umbilical cord magnesium levels at delivery. In regression models that controlled for confounders, which included very low birth weight, magnesium remained a significant risk factor (adjusted odds ratio, 3.7; 95% CI, 1.1-11.9; P =.03).
  
  
  CONCLUSIONS
  Contrary to original hypotheses, this randomized trial found that the use of antenatal magnesium sulfate was associated with worse, not better, perinatal outcome in a dose-response fashion.
authors.affiliation: Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL 60153, USA. rmitten@lumc.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Mittendorf
authors.forename: James
authors.initials: J
authors.lastname: Dambrosia
authors.forename: Peter G
authors.initials: PG
authors.lastname: Pryde
authors.forename: Kwang-Sun
authors.initials: KS
authors.lastname: Lee
authors.forename: John G
authors.initials: JG
authors.lastname: Gianopoulos
authors.forename: Richard E
authors.initials: RE
authors.lastname: Besinger
authors.forename: Paul G
authors.initials: PG
authors.lastname: Tomich
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000139:chemically induced*; D002547:Cerebral Palsy / Q000139:chemically induced*; D005260:Female; D005312:Fetal Blood; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007743:Labor, Obstetric; D007969:Leukomalacia, Periventricular / Q000139:chemically induced*; D008274:Magnesium / Q000097:blood; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011295:Prenatal Care; D012307:Risk Factors; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D015149:Tocolytic Agents; D008278:Magnesium Sulfate; D008274:Magnesium