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KMID : 1101620230340030105
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Perinatology
2023 Volume.34 No. 3 p.105 ~ p.113
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Long-Term Neuroprotective Effect and Safety of Antenatal Magnesium Sulfate on Preterm Infants
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Jeon Ga-Won
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Abstract
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In 2010, the American College of Obstetricians and Gynecologists (ACOG) issued a Committee Opinion regarding the administration of antenatal magnesium sulfate (MgSO4) for fetal neuroprotection based on randomized controlled trials and meta-analyses. ACOG recommends the use of antenatal MgSO4 for fetal neuroprotection. Consequently, antenatal MgSO4 is administered to pregnant women with a gestational age of less than 32 weeks to provide fetal neuroprotection and reduce the risk of cerebral palsy and neurodevelopmental impairment. Since the use of antenatal MgSO4 for fetal neuroprotection, concerns about the safety of the fetus and newborn and doubts about the long-term neuroprotective effects of antenatal MgSO4 have been raised. There is still in controversies whether antenatal MgSO4 provides short-term and long-term neuroprotection, such as decreased substantial gross motor dysfunction, cerebral palsy and cognitive dysfunction. Furthermore, the fetal and neonatal adverse effects of antenatal MgSO4, such as decreased vascular tone, blood flow of the mesenteric artery, and intestinal motility are still controversial. Therefore, preclinical studies and rigorous multicenter large cohort studies are necessary to determine the neuroprotective effects and safety of antenatal MgSO4, as well as to determine the optimal dosage and duration of treatment. It is important to administer MgSO4 to pregnant women with caution, taking into consideration the potential impact on the fetus and newborn.
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KEYWORD
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Magnesium sulfate, Neuroprotection, Cerebral palsy, Infant, Premature
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