Magnesium sulfate for neuroprotection in the setting of chorioamnionitis.

ABSTRACT

PURPOSE: We examined the effects of magnesium on premature neonatal outcomes complicated by chorioamnionitis. MATERIALS AND METHODS: We conducted a secondary analysis of data from the BEAM Trial, an RCT to determine if antenatal magnesium decreases the incidence of CP in preterm birth. We compared the effect of magnesium sulfate by the presence or absence of chorioamnionitis. Outcomes examined include CP, IVH, NEC, BPD, and assessments of mental and motor disability. Logistic regression was used to estimate adjusted odds ratios of each outcome. RESULTS: About 1944 women were included in this analysis of which 228 were diagnosed with chorioamnionitis. Demographic characteristics were similar between women randomized to receive magnesium or placebo. Magnesium therapy demonstrated no significant reduction in CP in the presence of chorioamnionitis (OR 0.76, CI 0.19-2.76) but does demonstrate benefit in the absence of chorioamnionitis (OR 0.52, CI 0.31-0.86). CONCLUSIONS: Antenatal magnesium did not show a clear neuroprotective effect in the setting of chorioamnionitis.