title: Does magnesium exposure affect neonatal resuscitation?
abstract: OBJECTIVE
  Research on immediate neonatal resuscitation suggests that maternal magnesium exposure may be associated with increased risk of low Apgar scores, hypotonia, and neonatal intensive care unit admission. However, not all studies support these associations. Our objective was to determine whether exposure to magnesium at the time of delivery affects initial neonatal resuscitation.
  
  
  METHODS
  This is a secondary analysis of the Randomized Controlled Trial of Magnesium Sulfate for the Prevention of Cerebral Palsy that evaluated whether the study drug (magnesium or placebo) that was administered at the time of delivery was associated with increased risk for a composite adverse neonatal resuscitation outcome (5-minute Apgar score <7, oxygen administration in the delivery room, intubation, chest compressions, hypotension, and hypotonicity). A subgroup analysis was performed among patients who delivered at ≥30 weeks of gestation. Log-linear regression was used to control for possible confounders.
  
  
  RESULTS
  Data for 1047 patients were analyzed, of whom 461 neonates (44%) were exposed to magnesium. There was no increased risk for the primary composite outcome associated with magnesium exposure. Individual adverse neonatal outcomes and other secondary short-term neonatal outcomes that were evaluated also did not demonstrate an association with magnesium exposure.
  
  
  CONCLUSIONS
  Exposure to magnesium sulfate did not affect neonatal resuscitation or other short-term outcomes. These findings may be useful in planning neonatal care and patient counseling.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY. Electronic address: dd2573@cumc.columbia.edu.
authors.forename: Daphnie
authors.initials: D
authors.lastname: Drassinower
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Friedman
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY.
authors.forename: Heather
authors.initials: H
authors.lastname: Levin
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Običan
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gyamfi-Bannerman
mesh_terms: D001034:Apgar Score; D002547:Cerebral Palsy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D016014:Linear Models; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D009123:Muscle Hypotonia / Q000139:chemically induced; D018696:Neuroprotective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D047928:Premature Birth; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*; D012151:Resuscitation
chemical_list: D018696:Neuroprotective Agents; D008278:Magnesium Sulfate
keywords: immediate neonatal resuscitation; magnesium sulfate; neonatal outcome; neuroprotection