title: Antenatal magnesium sulfate and spontaneous intestinal perforation in infants less than 25 weeks gestation.
abstract: OBJECTIVE
  Evaluate spontaneous intestinal perforation (SIP)/death among extremely low birthweight (ELBW) infants before, during and after initiation of an antenatal magnesium for neuroprotection protocol (MgPro).
  
  
  METHODS
  We tested associations between SIP/death and magnesium exposure, gestational age (GA) and interactions with GA and magnesium exposure in a cohort of inborn ELBW infants before, during and after MgPro.
  
  
  RESULTS
  One hundred and fifty-five ELBW infants were included, 81 before, 23 during and 51 after MgPro. ELBW infants (78.3%) were exposed to Mg during MgPro compared with 50.6% and 60.8% before and after, respectively. Incidence of SIP on protocol was 30.4% vs 12.9% off protocol (P=0.03). GA was strongly associated with SIP (P<0.01). Antenatal Mg dose was also associated with SIP/death regardless of epoch (odds ratio 9.3 (1.04-104.6)), but increased SIP/death was limited to those <25 weeks gestation.
  
  
  CONCLUSIONS
  Higher Mg dose was associated with higher SIP and death risk among infants with the lowest birthweights. Validation of this observation in larger populations is warranted.
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Rattray
authors.affiliation: Department of Maternal-Fetal Medicine/Obstetrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Kraus
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Drinker
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: R N
authors.initials: RN
authors.lastname: Goldberg
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: D T
authors.initials: DT
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Cotten
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000139:chemically induced*; D007416:Intestinal Perforation / Q000139:chemically induced*; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D015999:Multivariate Analysis; D018696:Neuroprotective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D018696:Neuroprotective Agents; D015149:Tocolytic Agents; D008278:Magnesium Sulfate