Elsevier

The Journal of Pediatrics

Volume 100, Issue 2, February 1982, Pages 272-276
The Journal of Pediatrics

Neurobehavioral effects of neonatal hypermagnesemia

https://doi.org/10.1016/S0022-3476(82)80654-9Get rights and content

To investigate the effects on the newborn infant of maternal magnesium therapy for treatment of pre-eclampsia, we studied 36 hypermagnesemic infants born to pre-eclamptic mothers treated with MgSO4, 18 neonates born to untreated pre-eclamptic mothers, and 25 infants born to normal mothers. Impairment of neuromuscular transmission, as well as neurobehavioral differences when compared to controls, were found in hypermagnesemic infants. Awareness of the changes produced in the neonate by magnesium is important for accurate clinical assessment of the infant's condition, as well as for anticipating the postnatal interaction of magnesium with other drugs administered during labor and delivery.

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    Rather, the confounding circumstances associated with maternal MgSO4 treatment (eg, early gestational age) may increase the likelihood of respiratory depression immediately after birth, thus leading to increased receipt of delivery room resuscitation. The literature related to intrapartum MgSO4 exposure primarily addresses neonates born to mothers with preeclampsia or eclampsia as the indication for Mg exposure.17-19 Few studies have focused exclusively on preterm infants, and most studies have reported only Apgar scores or clinically subjective assessment scales as surrogate markers of the presumed impact of Mg exposure on delivery room resuscitation.

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    Although this report suggested a deleterious dose-dependent neonatal effect of maternal magnesium sulfate therapy for eclampsia prophylaxis, others questioned this link.10 Subsequently, however, Rasch et al11 demonstrated that neonates of preeclamptic mothers who were exposed in utero to magnesium sulfate showed significantly decreased neuromuscular response with direct nerve stimulation, compared with a group both with and without preeclamptic mothers who were not treated with magnesium. These findings correlated clinically with lower neurologic scores on the Dubowitz et al12 examination among magnesium-exposed neonates who were tested within the first 48 hours after birth, when compared with nonexposed control babies.

  • Hormones and Disorders of Mineral Metabolism

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Presented in part at the annual meeting of the Society for Pediatric Research, San Francisco, California, 1981.

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