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Does magnesium sulfate exposure attenuate the effect of steroids administered for fetal lung maturation?
Abstract Number: SA-32
Abstract Type: Original Research
Objective: Tocolysis with magnesium sulfate (MgSO4) may often be considered for women with PPROM who receive steroids. Data from animal studies suggest that MgSO4 can interfere with the fetal lung maturation effect of corticosteroids through an intracellular calcium-dependent mechanism. However, there is a dearth of clinical data to verify this phenomenon. In this retrospective study, we examined whether fetal exposure to MgSO4 among women with PPROM receiving steroids is associated with an increased risk of respiratory neonatal morbidity.
Methods: This is a secondary analysis of the MFMU BEAM study. We included all women who received one course of antenatal steroids and had PPROM at < 32 wks. We compared rates of respiratory distress syndrome (RDS) and the need for ventilator support for infants born to women who received MgSO4 compared to those born to mothers who received placebo. To account for potential confounders, we performed multivariate logistic regression, adjusting for diabetes, delivery route, other tocolytics, and gestational age at delivery.
Results: Our cohort comprised 1496 women who received one course of steroids and had PPROM; 735 (49.1%) women received MgSO4 and 761 (50.9%) women received placebo. We observed a lower likelihood of RDS and ventilatory support among infants exposed to MgSO4 compared to non-exposed infants (table). After adjustment, the risk of RDS and need for ventilator support did not differ according to MgSO4 exposure.
Conclusions: Among women receiving steroids for PPROM, our findings suggest that the risk of neonatal respiratory morbidity is not adversely influenced by fetal exposure to MgSO4.