Neuroprotective effects of antenatal magnesium sulfate on neurodevelopmental outcomes in very low birth weight preterm infants: A 2-year follow-up study

Antenatal magnesium sulfate (MgSO4) may provide neuroprotective benefits in preterm infants. This study examined the impact of antenatal MgSO4 on the neurodevelopmental outcomes of very low birth weight (VLBW) preterm infants at the corrected age of 2 years. This retrospective follow-up study included preterm infants with a birth weight ≤ 1500 g and gestational age ≤ 36 weeks who participated in a follow-up program. Antenatal MgSO4 was administered to treat maternal preeclampsia or for neuroprotection or tocolysis. Neurodevelopmental outcomes, including cerebral palsy (CP), neurodevelopmental impairment (NDI), and audiologic and visual assessments, were evaluated at a corrected age of 2 years. Infants exposed to MgSO4 were compared with unexposed controls. Among 328 VLBW infants (2007-2015), 133 were exposed to MgSO4, and 195 were not. Follow-up data were available for 93.3% of the infants. CP occurred in 6.0% of MgSO4 exposed infants versus 13.8% of controls (odds ratio: 0.39; 95% confidence interval: 0.18-0.91; P = .03). NDI was observed in 19.5% of exposed infants compared with 31.3% of controls (odds ratio: 0.53; 95% confidence interval: 0.32-0.90; P = .02). Multivariate logistic regression showed that low parental educational level (<college), birth weight (<1000 g), and periventricular leukomalacia were significantly associated with an increased rate of CP. Similarly, independent factors such as preeclampsia, low socioeconomic status, birth weight < 1000 g, male sex, and periventricular leukomalacia were significantly associated with an increased risk of NDI. Antenatal MgSO4 administration in pregnant women may have neuroprotective effects in VLBW preterm infants, reducing the risk of CP and NDI at the corrected age of 2 years.