Maternal and neonatal outcomes following magnesium sulfate in the setting of chorioamnionitis: a meta-analysis.

Autor: Pergialiotis V; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Sapantzoglou I; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Rodolaki K; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Varthaliti A; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Theodora M; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Antsaklis P; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Thomakos N; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Stavros S; Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Daskalakis G; First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece., Papapanagiotou A; Third Department of Obstetrics and Gynecology, Attikon General Hospital, National and Kapodistrian University of Athens, 2, Lourou Str., 11523, Athens, Greece. scriptamanem@yahoo.gr.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2024 Mar; Vol. 309 (3), pp. 917-927. Date of Electronic Publication: 2023 Sep 28.
DOI: 10.1007/s00404-023-07221-3
Abstrakt: Purpose: Magnesium sulfate (MgSO 4 ) has been widely used in obstetrics as a mean to help decrease maternal and neonatal morbidity in various antenatal pathology. As a factor, it seems to regulate immunity and can, thus, predispose to infectious morbidity. To date, it remains unknown if its administration can increase the risk of chorioamnionitis. In the present meta-analysis, we sought to accumulate the available evidence.
Methods: We systematically searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases in our primary search along with the reference lists of electronically retrieved full-text papers.
Results: Eight studies were included that investigated the incidence of chorioamnionitis among parturient that received MgSO 4 and control patients. Magnesium sulfate was administered in 3229 women and 3330 women served as controls as they did not receive MgSO 4 . The meta-analysis of data revealed that there was no association between the administration of magnesium sulfate and the incidence of chorioamnionitis (OR 0.98, 95% CI 0.73, 1.32). Rucker's analysis revealed that small studies did not significantly influence the statistical significance of this finding (OR 1.12, 95% CI 0.82, 1.53). Trial sequential analysis revealed that the required number to safely interpret the primary outcome was not reached. Two studies evaluated the impact of MgSO 4 in neonates delivered in the setting of chorioamnionitis. Neither of these indicated the presence of a beneficial effect in neonatal morbidity, including the risk of cerebral palsy, intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, stillbirth, or neonatal death.
Conclusion: Current evidence indicates that magnesium sulfate is not associated with an increased risk of maternal chorioamnionitis. However, it should be noted that its effect on neonatal outcomes of offspring born in the setting of chorioamnionitis might be subtle if any, although the available evidence is very limited.
(© 2023. The Author(s).)
Databáze: MEDLINE
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