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Effect of Intravenous Magnesium Sulphate on in-Hospital Mortality in Neonates with Perinatal Asphyxia: A Prospective Cohort Study
DOI:
https://doi.org/10.21649/akemu.v29i2.5442Keywords:
Magnesium Sulphate, Mortality, Asphyxia Neonatorum, NewbornAbstract
Background: Early neonatal deaths in Pakistan account for 7% of global neonatal mortality rate, with perinatal asphyxia being responsible for 23% of these cases. Controversy exists in the literature regarding role of magnesium sulphate administration on reducing in-hospital mortality in newborns with perinatal asphyxia. Objectives: To determine the effect of intravenous magnesium sulphate on in-hospital mortality in neonates with perinatal asphyxia. Methods: This prospective cohort study was conducted at the Department of Pediatric Medicine, Nishtar Hospital Multan over a period of six months from January 2022 to June 2022. A total of 183 consecutive full-term neonates, weighing ≥ 2500 grams, with Apgar score < 7 at 5-minutes after birth, presenting within 48-hours of life were included in the study. Neonates presenting within 6-hours after birth received intravenous magnesium sulphate (MgSO4) – exposed group and neonates presenting after 6-hours did not get MgSO4 – unexposed group. Baseline characteristics and survival outcome was recorded. Binary logistic regression analysis was run and Kaplan-Meier survival curve is constructed for the assessment of mortality. Results: There were 90 neonates in exposed group and 93 in unexposed group. Males constituted 53% of the study population. Overall mortality rate was 15.8% (n=29). Severe asphyxia (RR 8.5, 95% CI 4.0 – 18.0; p < 0.001) and spontaneous vaginal delivery (RR 1.8, 95% CI 1.1 – 2.9; p = 0.02) were the independent predictors of mortality. Mortality (7.8% vs. 23.6%, p-value 0.003) was significantly higher in unexposed group compared to exposed group. In exposed group the median survival time was 16 days (95% CI- 8.7 – 23.3) compared to 11 days (95% CI 9.9 – 12.0) in unexposed group (Log-rank test: χ2 = 6.03, df -1, p = 0.01). Conclusion: Magnesium sulphate was effective in lowering neonatal mortality due to moderate-severe perinatal asphyxia. In order to further validate its impact on mortality, multi-center studies are suggested.
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07/31/2023 — Updated on 08/10/2023
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How to Cite
Rasheed, J. ., Khalid, M. ., Maryam, B. ., & Parveen, S. . (2023). Effect of Intravenous Magnesium Sulphate on in-Hospital Mortality in Neonates with Perinatal Asphyxia: A Prospective Cohort Study. Annals of King Edward Medical University, 29(2). https://doi.org/10.21649/akemu.v29i2.5442 (Original work published July 31, 2023)
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