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Antenatal exposure to magnesium sulfate and neonatal outcomes in very low birth weight infants: a multicenter study



To explore the association between antenatal magnesium sulfate (MgSO4), mortality and incidence of intraventricular hemorrhage (IVH) in very low birth weight (VLBW) infants.

Study design

Retrospective, cohort study of infants <32 weeks’ GA born at centers of NEOCOSUR Network between January 2015 and December 2020. Subjects were categorized as exposed vs non-exposed to antenatal MgSO4. Primary outcomes were death, incidence of severe IVH (Grade III-IV) and severe IVH/death. Secondary outcomes included relevant morbidities.


7418 VLBW infants were eligible. Antenatal MgSO4 was associated with a significantly decreased death rate after admission (aOR 0.67 [95% CI, 0.49–0.94]) and severe IVH/ death (aOR 0.68 [95% CI, 0.50–0.93]). No significant reduction in severe IVH was observed (aOR 1.11 [95% CI, 0.72–1.71]). No differences between groups were observed in rates of morbidities.


Antenatal MgSO4 was associated with a decreased death rate after admission and in severe IVH/ death.

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  1. Cahill AG, Caughey AB. Magnesium for neuroprophylaxis: fact or fiction? Am J Obstet Gynecol. 2009;200:590–4.

    Article  CAS  PubMed  Google Scholar 

  2. Shennan A, Suff N, Jacobsson B. FIGO good practice recommendations on magnesium sulfate administration for preterm fetal neuroprotection. Int J Gynecol Obstet. 2021;155:31–33.

    Article  CAS  Google Scholar 

  3. Marret S, Doyle LW, Crowther CA, Middleton P. Antenatal magnesium sulphate neuroprotection in the preterm infant. Semin Fetal Neonatal Med. 2007;12:311–7.

    Article  PubMed  Google Scholar 

  4. Hirtz DG, Weiner SJ, Bulas D, DiPietro M, Seibert J, Rouse DJ, et al. Antenatal Magnesium and Cerebral Palsy in Preterm Infants. J Pediatrics. 2015;167:834–839.e3.

    Article  CAS  Google Scholar 

  5. Lw D, Ca C, Middleton P, Rouse MS. Magnesium Sulphate for Women at Risk of Preterm Birth for Neuroprotection of the Fetus. Cochrane Database Syst Rev. 2009;1:CD004661.

  6. Zeng X, Xue Y, Tian Q, Sun R, An R. Effects and Safety of Magnesium Sulfate on Neuroprotection: A Meta-analysis Based on PRISMA Guidelines. Medicine. 2016;95:e2451.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Moradi Y, Khateri R, Haghighi L, Dehghani S, Hanis SM, Valipour M, et al. The effect of antenatal magnesium sulfate on intraventricular hemorrhage in premature infants: a systematic review and meta-analysis. Obstet Gynecol Sci. 2020;63:395–406.

    Article  PubMed  PubMed Central  Google Scholar 

  8. D’Apremont I, Marshall G, Musalem C, Mariani G, Musante G, Bancalari A, et al. Trends in Perinatal Practices and Neonatal Outcomes of Very Low Birth Weight Infants during a 16-year Period at NEOCOSUR Centers. J Pediatrics. 2020;225:44–50.e1.

    Article  Google Scholar 

  9. Gano D, Ho ML, Partridge JC, Glass HC, Xu D, Barkovich AJ, et al. Antenatal Exposure to Magnesium Sulfate Is Associated with Reduced Cerebellar Hemorrhage in Preterm Newborns. J Pediatr. 2016:178:68–74.

  10. Jameson RA, Bernstein HB. Magnesium Sulfate and Novel Therapies to Promote Neuroprotection. Clin Perinatol. 2019;46:187–201.

    Article  PubMed  Google Scholar 

  11. Stockley EL, Ting JY, Kingdom JC, McDonald SD, Barrett JF, Synnes AR, et al. Intrapartum magnesium sulfate is associated with neuroprotection in growth-restricted fetuses. Am J Obstet Gynecol. 2018;219:606.e1–606.e8.

    Article  CAS  PubMed  Google Scholar 

  12. Nelson KB, Grether JK. Can magnesium sulfate reduce the risk of cerebral palsy in very low birthweight infants? Pediatrics. 1995;95:263–9.

    Article  CAS  PubMed  Google Scholar 

  13. Rouse DJ, Hirtz DG, Thom E, Varner MW, Spong CY, Mercer BM. et al. A Randomized, Controlled Trial of Magnesium Sulfate for the Prevention of Cerebral Palsy. N Engl J Med.2008;359:895–905.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Crowther CA, Middleton PF, Voysey M, Askie L, Duley L, Pryde PG, et al. Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant data meta-analysis. PLoS Med. 2017;14:e1002398.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Brookfield KF, Mbata O. Magnesium Sulfate Use in Pregnancy for Preeclampsia Prophylaxis and Fetal Neuroprotection: Regimens in High-Income and Low/Middle-Income Countries. Obstet Gynecol Clin North Am. 2023;50:89–99.

    Article  PubMed  Google Scholar 

  16. Drassinower D, Friedman AM, Levin H, Običan SG, Gyamfi-Bannerman C. Does magnesium exposure affect neonatal resuscitation? Am J Obstetr Gynecol. 2015;213:424.e1-424.e5.

  17. Magee LA, De Silva DA, Sawchuck D, Synnes A, von Dadelszen P. No. 376-Magnesium Sulphate for Fetal Neuroprotection. J Obstet Gynaecol Can. 2019;41:505–22.

    Article  PubMed  Google Scholar 

  18. Shepherd E, Salam RA, Manhas D, Synnes A, Middleton P, Makrides M, et al. Antenatal magnesium sulphate and adverse neonatal outcomes: A systematic review and meta-analysis. PLoS Med. 2019;16:e1002988.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Weisz DE, Shivananda S, Asztalos E, Yee W, Synnes A, Lee SK, et al. Intrapartum magnesium sulfate and need for intensive delivery room resuscitation. Arch Dis Child Fetal Neonatal Ed. 2015;100:F59–65.

    Article  PubMed  Google Scholar 

  20. Prasath A, Aronoff N, Chandrasekharan P, Diggikar S. Antenatal Magnesium Sulfate and adverse gastrointestinal outcomes in Preterm infants—a systematic review and meta-analysis. J Perinatol. 2023;43:1087–1100.

    Article  PubMed  Google Scholar 

  21. Edwards HB, Redaniel MT, Sillero-Rejon C, Margelyte R, Peters TJ, Tilling K, et al. Arch Dis Child Fetal Neonatal Ed. Fantoms 2023;108:F342–F347.

    Google Scholar 

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Authors would like to thank all the NEOCOSUR Neonatal Network members who took part in this study and the Database Unit.

NEOCOSUR Neonatal Network

Catalina Vaz Ferreira1, Jose Caro2, Luis Villarroel3, Patricia Alvarez2, Gerardo Flores2, Tamara Herrera1, Alberto Toso5, Paulina Toso5, Jose L. Tapia5

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Authors and Affiliations




Catalina Vaz Ferreira: Conceptualization, investigation, writing- original draft and visualization. José Caro: Conceptualization, methodology, investigation, writing- review and editing. Luis Villarroel: Methodology, software, formal analysis, and validation. Sergio Muñoz: Investigation. Patricia Alvarez: Investigation. Gerardo Flores: Investigation. Tamara Herrera: Investigation. Alberto Toso: Conceptualization, investigation, writing- review and editing and supervision. Paulina Toso: Investigation and supervision. José LTapia: Conceptualization, methodology, writing-review and editing, supervision, and project administration.

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Correspondence to Catalina Vaz Ferreira.

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Members of the NEOCOSUR Neonatal Network are listed below Acknowledgements.

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Vaz Ferreira, C., Caro, J., Villarroel, L. et al. Antenatal exposure to magnesium sulfate and neonatal outcomes in very low birth weight infants: a multicenter study. J Perinatol (2024).

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