LONG-TERM NEUROPROTECTION BY MATERNALLY-ADMINISTERED MAGNESIUM SULFATE(MgSO₄) IN PRETERM INFANTS IS RELATED TO INITIAL POST-NATAL SERUM MAGNESIUM LEVELS AND TO THE PRESENCE OF PRECEDING GRADE III/ IV INTRA

INTRODUCTION: The sole case-control trial delineating a reduction in cerebral palsy (CP) by maternally-administered MgSO₄ did not address the effect of Gr III/IV ICH or CPVL. We have described a similar neuroprotective effect of MgSO₄ in preventing long-term cerebral injury in preterm infants (CP, as well as scores > 2 SD's below the population mean on the Bayley Scales of Infant Development [BSID]). We speculated that the degree of neuroprotection may be related to maternal or initial neonatal serum magnesium (Mg) levels, to the duration of maternal therapy, or to the prior presence of Grade III or IV ICH or CPVL.METHODS: The mothers of 61 ventilated pre-term infants (< 33 wks GA) received MgSO₄ prior to delivery. 39 of the surviving infants were old enough (mean age 27.7 mo.) to undergo neurodevelopmental testing and physical assessment for findings of CP. 32/39 had serum Mg levels drawn on day 1 and comprise the study population. We ascertained the duration of maternal MgSO4 therapy and their serum Mg levels prior to delivery. RESULTS:Table CONCLUSION: Initial neonatal serum Mg levels in preterm infants, as well as the preceding presence of Gr III/IV ICH or CPVL, directly correlate with long-term neuroprotection. The degree of neuroprotection by maternal MgSO₄ beyond prevention of Gr III/IV ICH or CPVL is unclear.

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Supported by NIH 5RO1 HD21453-06.