Rantonen T, Kääpä P, Grönlund J, Ekblad U, Helenius H, Kero P, Välimäki I. Maternal magnesium sulfate treatment is associated with reduced brain-blood flow perfusion in preterm infants.
Crit Care Med 2001;
29:1460-5. [PMID:
11445708 DOI:
10.1097/00003246-200107000-00026]
[Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE
To examine the influence of antenatally administered magnesium sulfate (MgSO4) and ritodrine on cerebral blood flow and systemic hemodynamics in preterm infants.
DESIGN
Prospective, observational study.
SETTING
Neonatal intensive care unit of a university central hospital.
PATIENTS
Fifty-five preterm infants age <33 wks of gestation.
INTERVENTIONS
Serial Doppler examinations of the brain circulation, heart rate, systemic blood pressure, and echocardiographic assessment of ductus arteriosus shunting were performed during the first week of life in infants exposed antenatally to maternal MgSO4 (n = 19) or ritodrine treatment (n = 17), and in 19 nonexposed preterm controls.
MEASUREMENTS AND MAIN RESULTS
Cerebral blood flow velocity measurements were obtained from the anterior cerebral artery and internal carotid artery. Perfusion pressure and indices of resistance and blood flow in both vessels were subsequently derived. Maternal MgSO4 had no effect on neonatal cerebral blood flow velocity or resistance, but was associated with decreased (p <.05) perfusion pressure and blood flow in the anterior cerebral artery and internal carotid artery during the first day of life. Systolic blood pressure and pulse pressure were also lower (p <.05) during the whole study period in the MgSO4-exposed infants when compared with the controls. Maternal ritodrine treatment, on the other hand, had no consistent effects on either neonatal cerebral or systemic hemodynamics.
CONCLUSIONS
Our data indicate that maternal MgSO4 treatment, in contrast to antenatal ritodrine, is associated with lowered cerebral perfusion in preterm infants on the first day of life.
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