Maternal intravenous MgSO4 administration and its effects on neonatal respiratory function and risk of development of hemodynamically significant patent ductus arteriosus shunts during the initial 72 hours of life

B. W. Bonta, T. K. Chin, W. M. DeVoe

Research output: Contribution to journalArticle

Abstract

Tocolytic therapy with MgSO4 is well-tolerated with a low incidence of significant maternal side effects. There is evidence, however, that Mg++ accumulates in amniotic fluid with prolonged tocolysis, defined as > 72 hrs. Fetal swallowing of AF may account for the persistently higher levels seen. Objectives of this project were to track serum Mg++ levels among mothers admitted to the L&D Suite of the Johnson City Medical Center Hospital who required IV MgSO4 therapy > or < 72 hrs for control of pre-eclampsia or premature labor and who deliver their neonates while receiving such therapy. Neonatal Mg++ and Ca++ levels were obtained and infants followed for development of clinical signs and echocardiographic evidence of hsPDA with left to right shunts during the initial 72° life. Data collected between 11/95 to 9/98. Infants were divided into 3 groups: controls; IV MgSO4 exposure < 72° prior to delivery; and IV MgSO4 exposure > 72° prior to delivery. 36/102 (36%) control infants, 42/159 (26%) < 72° exposed infants and 20/36 (56%) infants > 72° exposure prior to delivery. parameter controls IV MgSO4 < 72° IV MgSO4 > 72°# 36 42 20 Birthweight 1296.2 (464-3330) 1024.0 (456-3219) 1021.6 (527-1715) Gestational Age 28.4 (23-36) 28.2 (22-33) 27.9 (24-33) Patients with hspdas (11/95-9/98) Results to date indicate higher average Mg++B among infants exposed to maternal MgSO4 > 72° than among those infants exposed < 72° or controls. Incidence of hsPDAs requiring indocin IV therapy > 2:1 (> 72° group vs < 72° group) without significant differences among BW or GA suggesting a ductal musculature relaxing effect resulting in a higher incidence of hsPDAs requiring indocin therapy.

Original languageEnglish (US)
Pages (from-to)119A
JournalJournal of Investigative Medicine
Volume47
Issue number2
StatePublished - Feb 1999

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Patent Ductus Arteriosus
Intravenous Administration
Tocolysis
Mothers
Tocolytic Agents
Indomethacin
Incidence
Amniotic Fluid
Deglutition
Gestational Age
Fluids
Therapeutics
Serum

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

@article{559f71d39d2b4046afb0169f2363e9fa,
title = "Maternal intravenous MgSO4 administration and its effects on neonatal respiratory function and risk of development of hemodynamically significant patent ductus arteriosus shunts during the initial 72 hours of life",
abstract = "Tocolytic therapy with MgSO4 is well-tolerated with a low incidence of significant maternal side effects. There is evidence, however, that Mg++ accumulates in amniotic fluid with prolonged tocolysis, defined as > 72 hrs. Fetal swallowing of AF may account for the persistently higher levels seen. Objectives of this project were to track serum Mg++ levels among mothers admitted to the L&D Suite of the Johnson City Medical Center Hospital who required IV MgSO4 therapy > or < 72 hrs for control of pre-eclampsia or premature labor and who deliver their neonates while receiving such therapy. Neonatal Mg++ and Ca++ levels were obtained and infants followed for development of clinical signs and echocardiographic evidence of hsPDA with left to right shunts during the initial 72° life. Data collected between 11/95 to 9/98. Infants were divided into 3 groups: controls; IV MgSO4 exposure < 72° prior to delivery; and IV MgSO4 exposure > 72° prior to delivery. 36/102 (36{\%}) control infants, 42/159 (26{\%}) < 72° exposed infants and 20/36 (56{\%}) infants > 72° exposure prior to delivery. parameter controls IV MgSO4 < 72° IV MgSO4 > 72°# 36 42 20 Birthweight 1296.2 (464-3330) 1024.0 (456-3219) 1021.6 (527-1715) Gestational Age 28.4 (23-36) 28.2 (22-33) 27.9 (24-33) Patients with hspdas (11/95-9/98) Results to date indicate higher average Mg++B among infants exposed to maternal MgSO4 > 72° than among those infants exposed < 72° or controls. Incidence of hsPDAs requiring indocin IV therapy > 2:1 (> 72° group vs < 72° group) without significant differences among BW or GA suggesting a ductal musculature relaxing effect resulting in a higher incidence of hsPDAs requiring indocin therapy.",
author = "Bonta, {B. W.} and Chin, {T. K.} and DeVoe, {W. M.}",
year = "1999",
month = "2",
language = "English (US)",
volume = "47",
pages = "119A",
journal = "Journal of Investigative Medicine",
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T1 - Maternal intravenous MgSO4 administration and its effects on neonatal respiratory function and risk of development of hemodynamically significant patent ductus arteriosus shunts during the initial 72 hours of life

AU - Bonta, B. W.

AU - Chin, T. K.

AU - DeVoe, W. M.

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N2 - Tocolytic therapy with MgSO4 is well-tolerated with a low incidence of significant maternal side effects. There is evidence, however, that Mg++ accumulates in amniotic fluid with prolonged tocolysis, defined as > 72 hrs. Fetal swallowing of AF may account for the persistently higher levels seen. Objectives of this project were to track serum Mg++ levels among mothers admitted to the L&D Suite of the Johnson City Medical Center Hospital who required IV MgSO4 therapy > or < 72 hrs for control of pre-eclampsia or premature labor and who deliver their neonates while receiving such therapy. Neonatal Mg++ and Ca++ levels were obtained and infants followed for development of clinical signs and echocardiographic evidence of hsPDA with left to right shunts during the initial 72° life. Data collected between 11/95 to 9/98. Infants were divided into 3 groups: controls; IV MgSO4 exposure < 72° prior to delivery; and IV MgSO4 exposure > 72° prior to delivery. 36/102 (36%) control infants, 42/159 (26%) < 72° exposed infants and 20/36 (56%) infants > 72° exposure prior to delivery. parameter controls IV MgSO4 < 72° IV MgSO4 > 72°# 36 42 20 Birthweight 1296.2 (464-3330) 1024.0 (456-3219) 1021.6 (527-1715) Gestational Age 28.4 (23-36) 28.2 (22-33) 27.9 (24-33) Patients with hspdas (11/95-9/98) Results to date indicate higher average Mg++B among infants exposed to maternal MgSO4 > 72° than among those infants exposed < 72° or controls. Incidence of hsPDAs requiring indocin IV therapy > 2:1 (> 72° group vs < 72° group) without significant differences among BW or GA suggesting a ductal musculature relaxing effect resulting in a higher incidence of hsPDAs requiring indocin therapy.

AB - Tocolytic therapy with MgSO4 is well-tolerated with a low incidence of significant maternal side effects. There is evidence, however, that Mg++ accumulates in amniotic fluid with prolonged tocolysis, defined as > 72 hrs. Fetal swallowing of AF may account for the persistently higher levels seen. Objectives of this project were to track serum Mg++ levels among mothers admitted to the L&D Suite of the Johnson City Medical Center Hospital who required IV MgSO4 therapy > or < 72 hrs for control of pre-eclampsia or premature labor and who deliver their neonates while receiving such therapy. Neonatal Mg++ and Ca++ levels were obtained and infants followed for development of clinical signs and echocardiographic evidence of hsPDA with left to right shunts during the initial 72° life. Data collected between 11/95 to 9/98. Infants were divided into 3 groups: controls; IV MgSO4 exposure < 72° prior to delivery; and IV MgSO4 exposure > 72° prior to delivery. 36/102 (36%) control infants, 42/159 (26%) < 72° exposed infants and 20/36 (56%) infants > 72° exposure prior to delivery. parameter controls IV MgSO4 < 72° IV MgSO4 > 72°# 36 42 20 Birthweight 1296.2 (464-3330) 1024.0 (456-3219) 1021.6 (527-1715) Gestational Age 28.4 (23-36) 28.2 (22-33) 27.9 (24-33) Patients with hspdas (11/95-9/98) Results to date indicate higher average Mg++B among infants exposed to maternal MgSO4 > 72° than among those infants exposed < 72° or controls. Incidence of hsPDAs requiring indocin IV therapy > 2:1 (> 72° group vs < 72° group) without significant differences among BW or GA suggesting a ductal musculature relaxing effect resulting in a higher incidence of hsPDAs requiring indocin therapy.

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