School-Age Outcomes of Antenatal Magnesium Sulphate in Preterm Infants

Author:

Kobayashi Akira1ORCID,Ito Masato2ORCID,Ota Erika34ORCID,Namba Fumihiko5ORCID

Affiliation:

1. General Center for Perinatal, Maternal and Neonatal Medicine, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan

2. Department of Pediatrics, Akita University Graduate School of Medicine, Akita 010-8543, Japan

3. Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan

4. Tokyo Foundation for Policy Research, Minato-ku, Tokyo 106-0032, Japan

5. Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, Japan

Abstract

Background: Antenatal magnesium sulphate (MgSO4) therapy given to women at risk of preterm birth reduced the risk of cerebral palsy in early childhood. However, its effect on longer-term neurological outcomes remains uncertain. This study aimed to assess the effects of antenatal MgSO4 therapy on school-age outcomes of preterm infants. Methods: We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, CENTRAL, and CINAHL for randomized controlled trials (RCTs). Two reviewers independently evaluated the eligibility for inclusion and extracted data. Results: Ten RCTs were included. Only two of them were on school-age outcomes. Antenatal MgSO4 therapy had no impact on cerebral palsy, hearing impairment, neurosensory disability, and death at school-age. Meta-analysis on mental retardation and visual impairment was not able to be performed due to different methods of evaluation. In the analysis of short-term outcomes conducted as secondary outcomes, antenatal MgSO4 therapy increased the risk of maternal adverse events with any symptom (3 RCTs; risk ratio 2.79; 95% confidence interval 1.10 to 7.05, low certainty of evidence) but was not associated with any neonatal symptoms. Conclusions: The number of cases was insufficient to determine the impact of antenatal MgSO4 therapy on school-age outcomes. Further accumulation of long-term data is required.

Funder

Neonatal Research Network (NRN) Japan

Publisher

MDPI AG

Subject

Pediatrics, Perinatology and Child Health

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