Association of Cord Blood Magnesium Concentration and Neonatal Resuscitation

Overview

Journal J Pediatr

Specialty Pediatrics

Date 2011 Nov 8

PMID 22056282

Citations 12

Authors

Lynn H Johnson

Delicia C Mapp

Dwight J Rouse

Catherine Y Spong

Brian M Mercer

Kenneth J Leveno

Michael W Varner

Jay D Iams

Yoram Sorokin

Susan M Ramin

Menachem Miodovnik

Mary J OSullivan

Alan M Peaceman

Steve N Caritis

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the relationship between umbilical cord blood magnesium concentration and level of delivery room resuscitation received by neonates.

Study Design: This was a secondary analysis of a controlled fetal neuroprotection trial that enrolled women at imminent risk for delivery between 24 and 31 weeks' gestation and randomly allocated them to receive either intravenous magnesium sulfate or placebo. The cohort included 1507 infants with data available on total cord blood Mg concentration and delivery room resuscitation. Multivariate logistic regression was used to estimate the association between cord blood Mg concentration and highest level of delivery room resuscitation, using the following hierarchy: none, oxygen only, bag-mask ventilation with oxygen, intubation, and chest compressions.

Results: There was no relationship between cord blood Mg and delivery room resuscitation (OR, 0.92 for each 1.0-mEq/L increase in Mg; 95% CI, 0.83-1.03). Maternal general anesthesia was associated with increased neonatal resuscitation (OR, 2.51; 95% CI, 1.72-3.68). Each 1-week increase in gestational age at birth was associated with decreased neonatal resuscitation (OR, 0.63; 95% CI, 0.60-0.66).

Conclusion: Cord blood Mg concentration does not correlate with the level of delivery room resuscitation of infants exposed to magnesium sulfate for fetal neuroprotection.

Citing Articles

Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus.

Shepherd E, Goldsmith S, Doyle L, Middleton P, Marret S, Rouse D Cochrane Database Syst Rev. 2024; 5:CD004661.

PMID: 38726883 PMC: 11082932. DOI: 10.1002/14651858.CD004661.pub4.

Cord Blood Haptoglobin, Cerebral Palsy and Death in Infants of Women at Risk for Preterm Birth: A Secondary Analysis of a Randomised Controlled Trial.

Buhimschi C, Jablonski K, Rouse D, Varner M, Reddy U, Mercer B EClinicalMedicine. 2019; 9:11-18.

PMID: 31143877 PMC: 6510719. DOI: 10.1016/j.eclinm.2019.03.009.

Antenatal prevention of cerebral palsy and childhood disability: is the impossible possible?.

Ellery S, Kelleher M, Grigsby P, Burd I, Derks J, Hirst J J Physiol. 2018; 596(23):5593-5609.

PMID: 29928763 PMC: 6265564. DOI: 10.1113/JP275595.

MAGnesium sulphate for fetal neuroprotection to prevent Cerebral Palsy (MAG-CP)-implementation of a national guideline in Canada.

De Silva D, Synnes A, von Dadelszen P, Lee T, Bone J, Magee L Implement Sci. 2018; 13(1):8.

PMID: 29325592 PMC: 5765609. DOI: 10.1186/s13012-017-0702-9.

Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants.

Bajaj M, Natarajan G, Shankaran S, Wyckoff M, Laptook A, Bell E J Pediatr. 2018; 195:33-38.e2.

PMID: 29306493 PMC: 5869086. DOI: 10.1016/j.jpeds.2017.11.039.

References

LIPSITZ P, ENGLISH I . Hypermagnesemia in the newborn infant. Pediatrics. 1967; 40(5):856-62. View

Crowther C, Hiller J, Doyle L, Haslam R . Effect of magnesium sulfate given for neuroprotection before preterm birth: a randomized controlled trial. JAMA. 2003; 290(20):2669-76. DOI: 10.1001/jama.290.20.2669. View

Hirtz D, Nelson K . Magnesium sulfate and cerebral palsy in premature infants. Curr Opin Pediatr. 1998; 10(2):131-7. DOI: 10.1097/00008480-199804000-00003. View

Aziz K, Chadwick M, Baker M, Andrews W . Ante- and intra-partum factors that predict increased need for neonatal resuscitation. Resuscitation. 2008; 79(3):444-52. DOI: 10.1016/j.resuscitation.2008.08.004. View

Riaz M, Porat R, Brodsky N, Hurt H . The effects of maternal magnesium sulfate treatment on newborns: a prospective controlled study. J Perinatol. 1998; 18(6 Pt 1):449-54. View

Mercer B, Merlino A . Magnesium sulfate for preterm labor and preterm birth. Obstet Gynecol. 2009; 114(3):650-668. DOI: 10.1097/AOG.0b013e3181b48336. View

LIPSITZ P . The clinical and biochemical effects of excess magnesium in the newborn. Pediatrics. 1971; 47(3):501-9. View

Herschel M, Mittendorf R . Tocolytic magnesium sulfate toxicity and unexpected neonatal death. J Perinatol. 2001; 21(4):261-2. DOI: 10.1038/sj.jp.7200498. View

Rouse D, Hirtz D, Thom E, Varner M, Spong C, Mercer B . A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med. 2008; 359(9):895-905. PMC: 2803083. DOI: 10.1056/NEJMoa0801187. View

10.

Carey J, Klebanoff M, Hauth J, Hillier S, Thom E, Ernest J . Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. N Engl J Med. 2000; 342(8):534-40. DOI: 10.1056/NEJM200002243420802. View

11.

Niermeyer S, Kattwinkel J, Van Reempts P, Nadkarni V, Phillips B, Zideman D . International Guidelines for Neonatal Resuscitation: An excerpt from the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science. Contributors and Reviewers for the Neonatal.... Pediatrics. 2000; 106(3):E29. DOI: 10.1542/peds.106.3.e29. View

12.

Macdonald H, Mulligan J, Allen A, Taylor P . Neonatal asphyxia. I. Relationship of obstetric and neonatal complications to neonatal mortality in 38,405 consecutive deliveries. J Pediatr. 1980; 96(5):898-902. DOI: 10.1016/s0022-3476(80)80574-9. View

13.

Teng R, Liu H, Tsou Yau K . Neonatal hypermagnesemia: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1989; 30(5):333-6. View

14.

Ramsey P, Rouse D . Magnesium sulfate as a tocolytic agent. Semin Perinatol. 2001; 25(4):236-47. DOI: 10.1053/sper.2001.27546. View

15.

Mattingly J, DAlessio J, Ramanathan J . Effects of obstetric analgesics and anesthetics on the neonate : a review. Paediatr Drugs. 2003; 5(9):615-27. DOI: 10.2165/00148581-200305090-00004. View

16.

Marret S, Marpeau L, Zupan-Simunek V, Eurin D, Leveque C, Hellot M . Magnesium sulphate given before very-preterm birth to protect infant brain: the randomised controlled PREMAG trial*. BJOG. 2006; 114(3):310-8. DOI: 10.1111/j.1471-0528.2006.01162.x. View

17.

Rasch D, Huber P, Richardson C, LHommedieu C, Nelson T, Reddi R . Neurobehavioral effects of neonatal hypermagnesemia. J Pediatr. 1982; 100(2):272-6. DOI: 10.1016/s0022-3476(82)80654-9. View

18.

Rantonen T, Ekblad U, Gronlund J, Rikalainen H, Valimaki I, Kero P . Influence of maternal magnesium sulphate and ritodrine treatment on the neonate: a study with six-month follow-up. Acta Paediatr. 1999; 88(10):1142-6. DOI: 10.1080/08035259950168234. View

19.

Levy B, Dawson J, Toth P, Bowdler N . Predictors of neonatal resuscitation, low Apgar scores, and umbilical artery pH among growth-restricted neonates. Obstet Gynecol. 1998; 91(6):909-16. DOI: 10.1016/s0029-7844(98)00094-5. View