Perinatology.  2023 Sep;34(3):105-113. 10.14734/PN.2023.34.3.105.

Long-Term Neuroprotective Effect and Safety of Antenatal Magnesium Sulfate on Preterm Infants

• Jeon GW

• KMID: 2546714
• DOI: http://doi.org/10.14734/PN.2023.34.3.105

Abstract

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 longterm 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.

Keyword

Magnesium sulfate; Neuroprotection; Cerebral palsy; Infant; Premature