MATERNALLY-ADMINISTERED MAGNESIUM SULFATE (MgSO₄) DECREASES THE INCIDENCE OF SEVERE NECROTIZING ENTEROCOLITIS (NEC) IN PRETERM INFANTS: A PROSPECTIVE STUDY. † 1501

INTRODUCTION: We and others have described a neuroprotective effect by maternally-administered MgSO₄ in reducing the incidence of severe intracranial hemorrhage, cystic periventricular leukomalacia, and long-term neurodevelopmental abnormalities in premature infants. NEC is another common disorder in preterm infants which may have a similar pathophysiologic basis as cerebral injury. We performed this investigation to test the hypothesis that maternally-administered MgSO₄ would decrease the incidence of severe NEC in preterm infants. METHODS: Our population was a cohort of 137 ventilated preterm infants (< 33 weeks gestational age) born between 1991 and 1994. We have prospectively followed these infants from birth to assess for early cerebral damage, as well as long-term neurodevelopmental outcome. The mothers of 61 of these infants (45%) received MgSO₄ prior to delivery for tocolysis (n=46), pregnancy-induced hypertension (n=13), or both (n=2). None of the remaining 76 mothers received antenatal MgSO₄. We reviewed the records of these infants to determine the incidence of NEC and its sequelae. RESULTS: 1/61 infants (1.6%) whose mothers received MgSO₄ subsequently developed NEC compared to 10/76 (13.2%) infants whose mothers did not (P=0.042) receive MgSO₄. CONCLUSION: Maternally-administered MgSO₄ provides protection against particularly virulent NEC. The specific mechanisms of this protection remain unknown. Supported in part by NIH 5RO1 HD21453-06. Table

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