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Magnesium tocolysis and neonatal bone abnormalities: a controlled study.

W L Holcomb1, G D Shackelford, R H Petrie

  • 1Department of Obstetrics and Gynecology, Washington University School of Medicine, Saint Louis, Missouri.

Obstetrics and Gynecology
|October 11, 1991
PubMed
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Maternal use of intravenous magnesium sulfate for over seven days may cause bone abnormalities in newborns. This study found a significant link between prolonged magnesium tocolysis and radiographic changes in neonatal long bones.

Area of Science:

  • Neonatal radiology
  • Maternal-fetal medicine
  • Pediatric bone health

Background:

  • Intravenous (IV) magnesium sulfate is used for tocolysis.
  • Prolonged maternal magnesium administration may affect fetal development.

Purpose of the Study:

  • To investigate the relationship between maternal IV magnesium sulfate administration and neonatal long bone radiographic abnormalities.
  • To determine if prolonged magnesium tocolysis impacts fetal bone mineralization.

Main Methods:

  • Retrospective review of neonatal chest radiographs.
  • Comparison of radiographic findings between neonates exposed to prolonged maternal IV magnesium sulfate and matched unexposed controls.
  • Radiologist blinded to exposure status.

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Main Results:

  • Six of eleven neonates exposed to prolonged IV magnesium sulfate (>7 days) showed radiographic abnormalities in proximal humeri.
  • Abnormalities included transverse radiolucent and/or sclerotic bands.
  • A statistically significant difference (P < .001) in radiographic findings was observed between exposed and unexposed groups.

Conclusions:

  • Prolonged maternal IV magnesium tocolysis is associated with abnormal fetal bone mineralization.
  • A causal relationship is suggested between magnesium tocolysis and neonatal bone changes.
  • Further research is needed to understand the mechanism and clinical significance of these bone changes.