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The effects of antenatal magnesium sulfate on feeding intolerance and necrotizing enterocolitis in preterm infants
Ipek Guney Varal1, Gaffari Tunc2, Hilal Kucuk3
1University of Health Sciences Bursa Yuksek Ihtisas Teaching Hospital, Department of Pediatrics, Division of Neonatology, Bursa, Türkiye, Türkiye. ipekguneyvaral@gmail.com.
Insights
Antenatal magnesium sulfate may increase feeding intolerance in preterm infants, but does not affect necrotizing enterocolitis. This finding is crucial for neonatal care providers managing high-risk pregnancies.
Area of Science:
- Neonatalogy
- Perinatology
- Pediatric Gastroenterology
Background:
- Antenatal magnesium sulfate is used for its tocolytic and neuroprotective benefits in preterm births.
- The impact on neonatal gastrointestinal outcomes requires further investigation.
Purpose of the Study:
- To evaluate the association between antenatal magnesium sulfate administration and feeding intolerance in preterm infants.
- To assess the effect on necrotizing enterocolitis and spontaneous intestinal perforation.
Main Methods:
- Observational cohort study of preterm infants (< 30 weeks gestational age or < 1250 g).
- Infants were divided into two groups: those who received antenatal magnesium sulfate and those who did not.
- Logistic regression analysis was used to identify independent risk factors for feeding intolerance.
Main Results:
- Infants receiving antenatal magnesium sulfate had a shorter time to full enteral feeding and less total parenteral nutrition.
- Magnesium sulfate administration was identified as an independent risk factor for feeding intolerance (adjusted OR: 3.5).
- No significant effect was observed on spontaneous intestinal perforation or necrotizing enterocolitis.
Conclusions:
- Antenatal magnesium sulfate may increase the risk of feeding intolerance in preterm infants.
- It does not appear to increase the risk of necrotizing enterocolitis or intestinal perforation.
- Clinicians should consider the potential for feeding intolerance when administering antenatal magnesium sulfate.
Objectives:
To investigate the effects of antenatal magnesium sulfate administration on preterm gastrointestinal feeding intolerance and necrotizing enterocolitis in preterm infants.
Material And Methods:
This observational cohort, single-centre study included preterm infants < 30 weeks gestational age or < 1250 g, who were admitted to the neonatal intensive care unit of a university hospital. These infants were divided into two groups on the basis of having received antenatal magnesium sulfate or not.
Results:
Overall, 118 preterm infants were enrolled. Fifty-four of these infants had received prenatal magnesium sulfate (Group 1), and 64 (42%) had not (Group 2) before their neonatal intensive care unit (NICU) admission. The number of days to full eneteral feeding and the days of total parenteral nutrition were significantly higher in Group 2 than in Group 1 (p < 0.05). When gestational age, birth weight, and small for gestational age (SGA) were included as factors affecting feeding intolerance, the logistic regression analysis results showed that the administration of magnesium sulfate was an independent risk factor (adjusted OR: 3.5; 95% CI: 1.462-8.615; p < 0.05). Antenatal magnesium sulfate administration was not observed to have an effect on spontaneous intestinal perforation and necrotising enterocolitis.
Conclusions:
The administration of antenatal magnesium sulfate has proven tocolytic and neuroprotective effects on preterm births. However, it must be taken into consideration that it can cause feeding intolerance in preterm infants without causing intestinal injury.
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