title: Effects of antenatal magnesium sulfate treatment for neonatal neuro-protection on cerebral oxygen kinetics.
abstract: BACKGROUND
  The underlying neuro-protective mechanisms of antenatal magnesium sulfate (MgSO(4)) in infants born preterm remain poorly understood. Early neonatal brain injury may be preceded by low cerebral blood flow (CBF) and elevated cerebral fractional tissue oxygen extraction (cFTOE). This study investigated the effect of antenatal MgSO(4) on cerebral oxygen delivery, consumption, and cFTOE in preterm infants.
  
  
  METHODS
  CBF and tissue oxygenation index were measured, and oxygen delivery, consumption, and cFTOE calculated within 24 h of birth and at 48 and 72 h of life in 36 infants ≤ 30 wk gestation exposed to MgSO(4) and 29 unexposed infants.
  
  
  RESULTS
  Total internal carotid blood flow and cerebral oxygen delivery did not differ between the groups at the three study time-points. Cerebral oxygen consumption and cFTOE were lower in infants exposed to antenatal MgSO(4) (P = 0.012) compared to unexposed infants within 24 h of delivery. This difference was not evident by 48 h of age. Fewer infants in the MgSO(4) group developed P/IVH by 72 h of age (P = 0.03).
  
  
  CONCLUSIONS
  Infants exposed to MgSO(4) had similar systemic and cerebral hemodynamics but lower cFTOE compared to nonexposed. These findings suggest reduced cerebral metabolism maybe a component of the neuro-protective actions of antenatal MgSO(4).
authors.affiliation: 1] Robinson Research Institute & School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia [2] Department of Neonatology, Women's & Children's Hospital, North Adelaide, South Australia, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stark
authors.affiliation: Robinson Research Institute & School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia.
authors.forename: Nicolette A
authors.initials: NA
authors.lastname: Hodyl
authors.affiliation: 1] Robinson Research Institute & School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia [2] Department of Neonatology, Women's & Children's Hospital, North Adelaide, South Australia, Australia.
authors.forename: Chad C
authors.initials: CC
authors.lastname: Andersen
mesh_terms: D001921:Brain / Q000378:metabolism / Q000473:pathology*; D001930:Brain Injuries / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology; D002560:Cerebrovascular Circulation; D005260:Female; D005865:Gestational Age; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D007700:Kinetics; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D018811:Maternal Exposure; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010100:Oxygen / Q000378:metabolism* / Q000627:therapeutic use; D010101:Oxygen Consumption; D011247:Pregnancy; D011295:Prenatal Care; D019265:Spectroscopy, Near-Infrared; D015149:Tocolytic Agents / Q000627:therapeutic use
chemical_list: D018696:Neuroprotective Agents; D015149:Tocolytic Agents; D008278:Magnesium Sulfate; D010100:Oxygen