Term Neonatal Outcomes after Maternal Magnesium Sulfate Treatment for Seizure Prophylaxis

Abstract

Objective This study aimed to evaluate term neonatal outcomes after maternal magnesium sulfate (MgSO4) treatment for seizure prophylaxis. Study Design This was a single-site retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes from January 2013 through December 2020. Our primary outcome was neonatal intensive care unit (NICU) admission. We compared outcomes between women treated with MgSO4 for 24 hours or more and women treated with MgSO4 for less than 24 hours prior to delivery. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval (95% CI), controlling for variables with a p < 0.05 based on bivariable analysis. Results Of 834 women analyzed, 173 (20.7%) neonates were admitted to the NICU. Women treated with MgSO4 for 24 hours or more compared with women treated with MgSO4 for less than 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (27.3 vs. 18.9%; p = 0.01), neonates requiring immediate NICU admission (24.6 vs. 18.3%; p < 0.01), and NICU admission for neonatal lethargy. After adjusting for covariates, only NICU admission due to neonatal lethargy remained statistically significant (aOR: 4.78 [95% CI: 1.50–15.21]). Conclusion Prolonged MgSO4 treatment for 24 hours or more was associated with increased odds of term NICU admission due to neonatal lethargy. Key Points