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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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1619-3997
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Volume 42, Issue 2 (Mar 2014)

Issues

Neonatal serum magnesium concentrations are determined by total maternal dose of magnesium sulfate administered for neuroprotection

Pamela Borja-Del-Rosario
  • Division of Neonatology, Maimonides Infants and Children’s Hospital of Brooklyn, Brooklyn, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Sudeepta Kumar Basu
  • Division of Neonatology, Maimonides Infants and Children’s Hospital of Brooklyn, Brooklyn, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Shoshana Haberman / Alok Bhutada
  • Division of Neonatology, Maimonides Infants and Children’s Hospital of Brooklyn, Brooklyn, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Shantanu Rastogi
  • Corresponding author
  • Division of Neonatology, Maimonides Infants and Children’s Hospital of Brooklyn, Brooklyn, NY, USA
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2013-09-04 | DOI: https://doi.org/10.1515/jpm-2013-0151

Abstract

Background: Antenatal magnesium in preterm labor for neuroprotection decreases the incidence of cerebral palsy. However, there are no guidelines on the dose and duration of magnesium infusion for neuroprotection. As increased neonatal serum magnesium concentrations may be related to higher risk of morbidity and mortality, the role of total amount of magnesium and maternal serum magnesium concentrations associated with safe neonatal serum magnesium concentrations is not known.

Methods: A retrospective study was conducted on 289 mothers who received antenatal magnesium for neuroprotection as a loading dose of 4–6 g infused over 30 min, followed by a maintenance infusion of 1–2 g/h. Total magnesium dose infused to the mother and maternal serum magnesium concentrations were correlated with neonatal serum magnesium concentrations.

Results: Of the 289 mothers, 192 mother/baby dyads had all three measurements (maternal total magnesium dose, and maternal and neonatal serum magnesium concentrations). Magnesium infusion was continued beyond 24 h in 60 mothers. Total maternal magnesium dose at 24 and 48 h of infusion correlated with neonatal serum magnesium concentrations (r=0.55, P<0.0001 and r=0.35, P<0.0001, respectively), but not with maternal serum magnesium concentrations (r=0.004, P=0.98 and r=0.14, P=0.21). However, there was no correlation between the maternal and neonatal serum magnesium concentrations (r=0.10, P=0.15).

Conclusion: Total dose of magnesium infused to the mother correlates with neonatal serum magnesium concentrations. To keep neonatal serum magnesium concentrations within a range that is effective for neuroprotection and safe for the neonates, the total dose received by the mother needs to be monitored and limited.

Keywords: Magnesium; maternal; neonatal; neuroprotection; serum concentrations; total dose

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About the article

Corresponding author: Shantanu Rastogi, Division of Neonatology, Maimonides Infants and Children’s Hospital of Brooklyn, 4802 Tenth Ave F-113, Brooklyn, NY 11203, USA, Tel.: +1 718 283 8853, E-mail:


Received: 2013-06-24

Accepted: 2013-08-01

Published Online: 2013-09-04

Published in Print: 2014-03-01


Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2013-0151.

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