Stockley EL, et al. – Researchers conducted this retrospective cohort study to assess the neonatal and neurodevelopmental outcomes of growth-restricted fetuses born before 29 weeks’ gestation and exposed to maternal intrapartum magnesium sulphate. Findings suggested an association of intrapartum administration of magnesium sulphate to women with growth-restricted fetuses born before 29 weeks’ gestation with reduced odds of a composite of death or significant neurodevelopmental impairment.

Methods

• This study included infants born before 29 weeks’ gestation between 2010 and 2011 who were admitted to participating Canadian Neonatal Network units, and followed by the Canadian Neonatal Follow-up Network centers.
• Researchers characterized growth restriction either as estimated fetal or actual neonatal birth weight <10th percentile according to fetal or neonatal growth standards for gestational age and sex, respectively.
• They compared infants exposed to intrapartum magnesium sulphate with unexposed infants.
• Composite of death or significant neurodevelopmental impairment at 18-36 months’ corrected age was the primary outcome.
• Death or any neurodevelopmental impairment at 18-36 months’ corrected age were included secondary outcomes.
• In addition, neonatal morbidities were compared.

Results

• According to the findings, of the 336 growth-restricted fetuses, 112 (33%) received magnesium sulphate and, of the 177 growth-restricted infants, 61 (34%) received magnesium sulphate.
• They found that administration of magnesium sulphate was at the discretion of treating physician.
• There was a correlation between intrapartum magnesium sulphate and reduced odds of composite of death or significant neurodevelopmental impairment for infants classified according to both fetal standards (adjusted odds ratios [95% confidence interval], 0.42 [0.22-0.80]) and neonatal standards (0.44 [0.20-0.98]).