title: Antenatal magnesium sulfate exposure and acute cardiorespiratory events in preterm infants.
abstract: OBJECTIVE
  Antenatal magnesium (anteMg) is used for various obstetric indications including fetal neuroprotection. Infants exposed to anteMg may be at risk for respiratory depression and delivery room (DR) resuscitation. The study objective was to compare the risk of acute cardiorespiratory events among preterm infants who were and were not exposed to anteMg.
  
  
  METHODS
  This was a retrospective analysis of prospective data collected in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network's Generic Database from April 1, 2011, through March 31, 2012. The primary outcome was DR intubation or respiratory support at birth or on day 1 of life. Secondary outcomes were invasive mechanical ventilation, hypotension treatment, neonatal morbidities, and mortality. Logistic regression analysis evaluated the risk of primary outcome after adjustment for covariates.
  
  
  RESULTS
  We evaluated 1544 infants <29 weeks' gestational age (1091 in anteMg group and 453 in nonexposed group). Mothers in the anteMg group were more likely to have higher education, pregnancy-induced hypertension, and antenatal corticosteroids, while their infants were younger in gestation and weighed less (P < .05). The primary outcome (odds ratio [OR], 1.2; 95% confidence interval [CI], 0.88-1.65) was similar between groups. Hypotension treatment (OR, 0.70; 95% CI, 0.51-0.97) and invasive mechanical ventilation (OR, 0.54; 95% CI, 0.41-0.72) were significantly less in the anteMg group.
  
  
  CONCLUSIONS
  Among preterm infants age <29 weeks' gestation, anteMg exposure was not associated with an increase in cardiorespiratory events in the early newborn period. The safety of anteMg as measured by the need for DR intubation or respiratory support on day 1 of life was comparable between groups.
authors.affiliation: Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI. Electronic address: Lilia.DeJesus@UCSF.edu.
authors.forename: Lilia C
authors.initials: LC
authors.lastname: De Jesus
authors.affiliation: Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Beena G
authors.initials: BG
authors.lastname: Sood
authors.affiliation: Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.affiliation: Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC.
authors.forename: Douglas
authors.initials: D
authors.lastname: Kendrick
authors.affiliation: Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC.
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.affiliation: Department of Pediatrics, University of Iowa School of Medicine, Iowa City, IA.
authors.forename: Edward F
authors.initials: EF
authors.lastname: Bell
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stoll
authors.affiliation: Department of Pediatrics, Alpert Medical School, Brown University, Providence, RI.
authors.forename: Abbot R
authors.initials: AR
authors.lastname: Laptook
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Michele C
authors.initials: MC
authors.lastname: Walsh
authors.affiliation: Division of Neonatology, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
authors.affiliation: Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Sanchez
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
authors.forename: Krisa P
authors.initials: KP
authors.lastname: Van Meurs
authors.affiliation: Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bara
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
authors.forename: Ellen C
authors.initials: EC
authors.lastname: Hale
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Newman
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
authors.forename: M Bethany
authors.initials: MB
authors.lastname: Ball
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000139:chemically induced*; D008278:Magnesium Sulfate / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*; D012120:Respiration Disorders / Q000139:chemically induced*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D008278:Magnesium Sulfate
keywords: antenatal magnesium; nasal continuous positive airway pressure; neonatal resuscitation; preterm infants