Antenatal Magnesium Sulfate Is Not Associated with Improved Long-Term Neurodevelopment and Growth in Very Low Birth Weight Infants.

초록

Objective: Though antenatal magnesium sulfate (MgSO4) is widely used for fetal neuroprotection, suspicions about the long-term neuroprotection of antenatal MgSO4 have been raised. Therefore, this study aimed to investigate whether antenatal MgSO4 for fetal neuroprotection was clearly associated with improved long-term neurodevelopmental and growth outcomes without significant side effects in preterm infants with a gestational age (GA) of 24?31 weeks who are at great risk for long-term neurodevelopmental and growth impairment. Methods: Medical records of very low birth weight infants weighing < 1500 g with GA 24?31 weeks who were admitted to the Samsung Medical Center neonatal intensive care unit between January 2012 and March 2018 and were followed up at corrected age of 18?24 months (follow-up 1) or at 3 years of age (follow-up 2) were reviewed. Patient characteristics and long-term neurodevelopmental and growth outcomes were compared between two groups. Infants who were exposed to antenatal MgSO4 for any purpose (MgSO4 group) were compared with infants who were not exposed to antenatal MgSO4 (control group). Additionally, infants who were exposed to antenatal MgSO4 for fetal neuroprotection (neuroprotection group) were compared with the control group. Results: Short-term morbidities did not decrease in the MgSO4 group or neuroprotection group compared with the control group. The risk of mental developmental delay was higher in the neuroprotection group compared with the control group at follow-up 1. The risk of motor developmental delay, hearing loss, or cerebral palsy did not decrease in the MgSO4 group or neuroprotection group compared with the control group at follow-up 1. The risk of mental developmental delay, motor developmental delay, hearing loss, or cerebral palsy delay did not decrease in the MgSO4 group or neuroprotection group compared with the control group at follow-up 2. The z-score of weight, height, or head circumference at follow-up 1 did n