Abstract:

Aim: Antenatal magnesium sulfate administration has been shown to have a long-term neuroprotective effect, but its immediate impact on preterm infants' immediate neonatal outcomes remains subject of controversy. In this study, we aimed to investigate the effect of antenatal magnesium sulfate treatment on early cardiopulmonary functions and serum electrolytes in preterm infants born ≤32 gestational weeks. Material-Methods: We included preterm infants born ≤32 gestational weeks who were followed up in our unit and had their serum magnesium levels obtained within the first 48 hours postnatally. Infants with major congenital malformations, chromosomal abnormalities, and missing data were excluded. Infants born to mothers who received magnesium sulfate for preeclampsia or eclampsia were also excluded. The case group consisted of preterm infants born to mothers who received magnesium sulfate treatment for neuroprotection in the antenatal period due to the risk of preterm delivery, while the control group was matched one-to-one according to gestational week. We recorded demographic data including; need for resuscitation in the delivery room, need for surfactant, respiratory support on the first postnatal day, mean heart rate, mean blood pressure, and electrolyte values in the first 48 hours, as well as major morbidities and early mortality from patient files. Results: A total of 156 patients were included in the study, with 78 premature infants receiving magnesium sulfate for neuroprotection and 78 controls who did not. Gestational ages and birth weights were similar between the two groups. Maternal magnesium level and infant initial magnesium level were higher in the group receiving antenatal magnesium. The need for intubation at birth, presence of hypotension, mechanical ventilation support for the first 24 hours, the mean oxygen requirement for the first 24 hours, and mortality rate were not significantly different between the two groups. In the case group, the mean heart rate for the first 24 hours was lower but still >120/min. Conclusion: Our study findings suggest that antenatal use of magnesium sulfate for neuroprotection is safe in the early postnatal period in premature infants.

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