1. Antenatal Magnesium Sulfate and Preeclampsia Differentially Affect Neonatal Cerebral Oxygenation
- Author
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Arend F. Bos, Elisabeth M. W. Kooi, Anne E Richter, Riksta Dikkers, Sicco A. Scherjon, and Reproductive Origins of Adult Health and Disease (ROAHD)
- Subjects
EXTRACTION ,medicine.medical_specialty ,Gestational Age ,Neuroprotection ,Cerebral autoregulation ,Preeclampsia ,03 medical and health sciences ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,PRETERM INFANTS ,030225 pediatrics ,Internal medicine ,DOPPLER ULTRASOUND ,medicine ,Humans ,Autoregulation ,030212 general & internal medicine ,Fetus ,Eclampsia ,BLOOD-FLOW ,business.industry ,Infant, Newborn ,Blood flow ,Cerebral blood flow ,AUTOREGULATION ,medicine.disease ,Endocrinology ,Cerebral oxygenation ,ARTERIES ,Pediatrics, Perinatology and Child Health ,ECLAMPSIA ,Premature Birth ,Female ,business ,Fetal brain sparing ,Infant, Premature ,Magnesium sulfate ,Developmental Biology - Abstract
Introduction: Magnesium sulfate (MgSO4) is frequently administered for maternal and fetal neuroprotection in preeclampsia (PE) and imminent preterm birth, respectively. Objective: To assess whether MgSO4 affects neonatal cerebral oxygenation, blood flow, and cerebral autoregulation (CAR) during the first postnatal days independently from PE. Methods: 148 neonates 0.5) was determined. Linear mixed models were applied. Results: MgSO4 exposure was recorded in 77 neonates. Twenty-nine neonates were born following PE. MgSO4 independently lowered cFTOE (B: –0.026, 95% CI: –0.050 to 0.002, p < 0.05) but did not affect PSV and RI. PE was associated with a lower cFTOE (B: –0.041, 95% CI: –0.067 to –0.015, p < 0.05) and a tendency towards both lower PSV (B: –4.285, 95% CI: –9.067 to 0.497, p < 0.1) and more impaired CAR (B: 4.042, 95% CI: –0.028 to 8.112, p < 0.1), which seemed to be strongly mediated by fetal brain sparing. MgSO4 did not alter CAR. Conclusions: In contrast to fetal brain sparing in PE, MgSO4 seems to lower cFTOE by lowering cerebral oxygen demands in preterm neonates without affecting the cerebrovasculature.
- Published
- 2020
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