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Abstract
Discussion Forum (0)
Introduction: We sought to evaluate term neonatal outcomes in women treated with magnesium sulfate (MgSO4) for seizure prophylaxis.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
Introduction: We sought to evaluate term neonatal outcomes in women treated with magnesium sulfate (MgSO4) for seizure prophylaxis.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
Term Neonatal Outcomes after Maternal Magnesium Sulfate Treatment for Seizure Prophylaxis
Dr. Rebecca Chornock
Abstract
Discussion Forum (0)
Introduction: We sought to evaluate term neonatal outcomes in women treated with magnesium sulfate (MgSO4) for seizure prophylaxis.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
Introduction: We sought to evaluate term neonatal outcomes in women treated with magnesium sulfate (MgSO4) for seizure prophylaxis.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
Methods: This was a retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes at MedStar Washington Hospital Center (Washington, DC), from January 2013 through December 2018. All patients met criteria for MgSO4 treatment for seizure prophylaxis based on ACOG Task Force recommendations. Our primary outcome was neonatal intensive care unit (NICU) admission. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval, controlling for variables with a P < .05 based on bivariable analysis.
Results: Of 593 women analyzed, 136 (22.9%) neonates had a NICU admission. On average, women received 707 minutes and 27 grams of MgSO4 prior to delivery. Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to be nulliparous (p < .001), have a larger BMI (p=.01), report headaches (p=.03), have a higher creatinine level (p=.03), receive an induction agent (p < .001), and be diagnosed with chorioamnionitis (p=.02). Women that received MgSO4 for a duration equal to or exceeding 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (p=.02) and neonates requiring immediate NICU admission (p < .01). After adjusting for covariates, there was an increased risk for NICU admissions due to neonatal lethargy [aOR 3.54 (1.03-12.10)].
Conclusion/Implications: After adjusting for confounders, prolonged magnesium sulfate treatment increased the risk of neonatal lethargy leading to NICU admission.
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