The effects of antenatal magnesium sulfate on feeding intolerance and necrotizing enterocolitis in preterm infants.

Ipek Guney Varal, Gaffari Tunc, Hilal Kucuk, Dilge Sener, Ayse Oren
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Abstract

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.

产前硫酸镁对早产儿喂养不耐受和坏死性小肠结肠炎的影响。
目的:探讨产前硫酸镁对早产儿胃肠喂养不耐受和坏死性小肠结肠炎的影响。材料和方法:本观察性队列单中心研究纳入了一所大学附属医院新生儿重症监护室收治的< 30孕周或< 1250 g的早产儿。这些婴儿根据产前是否接受硫酸镁治疗分为两组。结果:共纳入118名早产儿。其中54名婴儿在新生儿重症监护病房(NICU)入院前接受过产前硫酸镁治疗(第一组),64名(42%)未接受过产前硫酸镁治疗(第二组)。组2至全肠喂养天数和全肠外营养天数均显著高于组1 (p < 0.05)。当纳入胎龄、出生体重和小胎龄(SGA)作为影响喂养不耐受的因素时,logistic回归分析结果显示,给药硫酸镁是一个独立的危险因素(调整OR: 3.5;95% ci: 1.462-8.615;P < 0.05)。未观察到产前硫酸镁给药对自发性肠穿孔和坏死性小肠结肠炎有影响。结论:产前应用硫酸镁对早产儿具有抗早产和神经保护作用。然而,必须考虑到它可以引起早产儿喂养不耐受,而不会造成肠道损伤。
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