Association of cord blood magnesium concentration and neonatal resuscitation

Lynn H. Johnson; Delicia C. Mapp; Dwight J. Rouse; Catherine Y. Spong; Brian M. Mercer; Kenneth J. Leveno; Michael W. Varner; Jay D. Iams; Yoram Sorokin; Susan M. Ramin; Menachem Miodovnik; Mary J. O'Sullivan; Alan M. Peaceman; Steve N. Caritis

doi:10.1016/j.jpeds.2011.09.016

Association of cord blood magnesium concentration and neonatal resuscitation

Lynn H. Johnson^*, Delicia C. Mapp, Dwight J. Rouse, Catherine Y. Spong, Brian M. Mercer, Kenneth J. Leveno, Michael W. Varner, Jay D. Iams, Yoram Sorokin, Susan M. Ramin, Menachem Miodovnik, Mary J. O'Sullivan, Alan M. Peaceman, Steve N. Caritis

^*Corresponding author for this work

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

31 Scopus citations

Abstract

Objective: To assess the relationship between umbilical cord blood magnesium concentration and level of delivery room resuscitation received by neonates. Study design: This was a secondary analysis of a controlled fetal neuroprotection trial that enrolled women at imminent risk for delivery between 24 and 31 weeks' gestation and randomly allocated them to receive either intravenous magnesium sulfate or placebo. The cohort included 1507 infants with data available on total cord blood Mg concentration and delivery room resuscitation. Multivariate logistic regression was used to estimate the association between cord blood Mg concentration and highest level of delivery room resuscitation, using the following hierarchy: none, oxygen only, bag-mask ventilation with oxygen, intubation, and chest compressions. Results: There was no relationship between cord blood Mg and delivery room resuscitation (OR, 0.92 for each 1.0-mEq/L increase in Mg; 95% CI, 0.83-1.03). Maternal general anesthesia was associated with increased neonatal resuscitation (OR, 2.51; 95% CI, 1.72-3.68). Each 1-week increase in gestational age at birth was associated with decreased neonatal resuscitation (OR, 0.63; 95% CI, 0.60-0.66). Conclusion: Cord blood Mg concentration does not correlate with the level of delivery room resuscitation of infants exposed to magnesium sulfate for fetal neuroprotection.

Original language	English (US)
Pages (from-to)	573-577.e1
Journal	journal of pediatrics
Volume	160
Issue number	4
DOIs	https://doi.org/10.1016/j.jpeds.2011.09.016
State	Published - Apr 2012

Funding

We thank the subcommittee members who participated in protocol development and coordination between clinical research centers (Allison T. Northen, MSN, RN), protocol/data management and statistical analysis (Elizabeth Thom, PhD and Steven J. Weiner, MS), and protocol development and oversight (Deborah G. Hirtz, MD and John M. Thorp, Jr, MD). We also thank Matthew M. Laughon, MD, MPH (supported by the US government for his work in pediatric and neonatal clinical pharmacology [ National Institutes of Health Grant 1K23HL092225-01 ]), University of North Carolina at Chapel Hill, for providing additional support with analysis and manuscript review.

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

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10.1016/j.jpeds.2011.09.016

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Johnson, L. H., Mapp, D. C., Rouse, D. J., Spong, C. Y., Mercer, B. M., Leveno, K. J., Varner, M. W., Iams, J. D., Sorokin, Y., Ramin, S. M., Miodovnik, M., O'Sullivan, M. J., Peaceman, A. M., & Caritis, S. N. (2012). Association of cord blood magnesium concentration and neonatal resuscitation. journal of pediatrics, 160(4), 573-577.e1. https://doi.org/10.1016/j.jpeds.2011.09.016

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title = "Association of cord blood magnesium concentration and neonatal resuscitation",

abstract = "Objective: To assess the relationship between umbilical cord blood magnesium concentration and level of delivery room resuscitation received by neonates. Study design: This was a secondary analysis of a controlled fetal neuroprotection trial that enrolled women at imminent risk for delivery between 24 and 31 weeks' gestation and randomly allocated them to receive either intravenous magnesium sulfate or placebo. The cohort included 1507 infants with data available on total cord blood Mg concentration and delivery room resuscitation. Multivariate logistic regression was used to estimate the association between cord blood Mg concentration and highest level of delivery room resuscitation, using the following hierarchy: none, oxygen only, bag-mask ventilation with oxygen, intubation, and chest compressions. Results: There was no relationship between cord blood Mg and delivery room resuscitation (OR, 0.92 for each 1.0-mEq/L increase in Mg; 95% CI, 0.83-1.03). Maternal general anesthesia was associated with increased neonatal resuscitation (OR, 2.51; 95% CI, 1.72-3.68). Each 1-week increase in gestational age at birth was associated with decreased neonatal resuscitation (OR, 0.63; 95% CI, 0.60-0.66). Conclusion: Cord blood Mg concentration does not correlate with the level of delivery room resuscitation of infants exposed to magnesium sulfate for fetal neuroprotection.",

author = "Johnson, {Lynn H.} and Mapp, {Delicia C.} and Rouse, {Dwight J.} and Spong, {Catherine Y.} and Mercer, {Brian M.} and Leveno, {Kenneth J.} and Varner, {Michael W.} and Iams, {Jay D.} and Yoram Sorokin and Ramin, {Susan M.} and Menachem Miodovnik and O'Sullivan, {Mary J.} and Peaceman, {Alan M.} and Caritis, {Steve N.}",

note = "Funding Information: We thank the subcommittee members who participated in protocol development and coordination between clinical research centers (Allison T. Northen, MSN, RN), protocol/data management and statistical analysis (Elizabeth Thom, PhD and Steven J. Weiner, MS), and protocol development and oversight (Deborah G. Hirtz, MD and John M. Thorp, Jr, MD). We also thank Matthew M. Laughon, MD, MPH (supported by the US government for his work in pediatric and neonatal clinical pharmacology [ National Institutes of Health Grant 1K23HL092225-01 ]), University of North Carolina at Chapel Hill, for providing additional support with analysis and manuscript review. ",

year = "2012",

month = apr,

doi = "10.1016/j.jpeds.2011.09.016",

language = "English (US)",

volume = "160",

pages = "573--577.e1",

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TY - JOUR

T1 - Association of cord blood magnesium concentration and neonatal resuscitation

AU - Johnson, Lynn H.

AU - Mapp, Delicia C.

AU - Rouse, Dwight J.

AU - Spong, Catherine Y.

AU - Mercer, Brian M.

AU - Leveno, Kenneth J.

AU - Varner, Michael W.

AU - Iams, Jay D.

AU - Sorokin, Yoram

AU - Ramin, Susan M.

AU - Miodovnik, Menachem

AU - O'Sullivan, Mary J.

AU - Peaceman, Alan M.

AU - Caritis, Steve N.

N1 - Funding Information: We thank the subcommittee members who participated in protocol development and coordination between clinical research centers (Allison T. Northen, MSN, RN), protocol/data management and statistical analysis (Elizabeth Thom, PhD and Steven J. Weiner, MS), and protocol development and oversight (Deborah G. Hirtz, MD and John M. Thorp, Jr, MD). We also thank Matthew M. Laughon, MD, MPH (supported by the US government for his work in pediatric and neonatal clinical pharmacology [ National Institutes of Health Grant 1K23HL092225-01 ]), University of North Carolina at Chapel Hill, for providing additional support with analysis and manuscript review.

PY - 2012/4

Y1 - 2012/4

N2 - Objective: To assess the relationship between umbilical cord blood magnesium concentration and level of delivery room resuscitation received by neonates. Study design: This was a secondary analysis of a controlled fetal neuroprotection trial that enrolled women at imminent risk for delivery between 24 and 31 weeks' gestation and randomly allocated them to receive either intravenous magnesium sulfate or placebo. The cohort included 1507 infants with data available on total cord blood Mg concentration and delivery room resuscitation. Multivariate logistic regression was used to estimate the association between cord blood Mg concentration and highest level of delivery room resuscitation, using the following hierarchy: none, oxygen only, bag-mask ventilation with oxygen, intubation, and chest compressions. Results: There was no relationship between cord blood Mg and delivery room resuscitation (OR, 0.92 for each 1.0-mEq/L increase in Mg; 95% CI, 0.83-1.03). Maternal general anesthesia was associated with increased neonatal resuscitation (OR, 2.51; 95% CI, 1.72-3.68). Each 1-week increase in gestational age at birth was associated with decreased neonatal resuscitation (OR, 0.63; 95% CI, 0.60-0.66). Conclusion: Cord blood Mg concentration does not correlate with the level of delivery room resuscitation of infants exposed to magnesium sulfate for fetal neuroprotection.

AB - Objective: To assess the relationship between umbilical cord blood magnesium concentration and level of delivery room resuscitation received by neonates. Study design: This was a secondary analysis of a controlled fetal neuroprotection trial that enrolled women at imminent risk for delivery between 24 and 31 weeks' gestation and randomly allocated them to receive either intravenous magnesium sulfate or placebo. The cohort included 1507 infants with data available on total cord blood Mg concentration and delivery room resuscitation. Multivariate logistic regression was used to estimate the association between cord blood Mg concentration and highest level of delivery room resuscitation, using the following hierarchy: none, oxygen only, bag-mask ventilation with oxygen, intubation, and chest compressions. Results: There was no relationship between cord blood Mg and delivery room resuscitation (OR, 0.92 for each 1.0-mEq/L increase in Mg; 95% CI, 0.83-1.03). Maternal general anesthesia was associated with increased neonatal resuscitation (OR, 2.51; 95% CI, 1.72-3.68). Each 1-week increase in gestational age at birth was associated with decreased neonatal resuscitation (OR, 0.63; 95% CI, 0.60-0.66). Conclusion: Cord blood Mg concentration does not correlate with the level of delivery room resuscitation of infants exposed to magnesium sulfate for fetal neuroprotection.

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SP - 573-577.e1

JO - journal of pediatrics

JF - journal of pediatrics

IS - 4

ER -

Association of cord blood magnesium concentration and neonatal resuscitation

Abstract

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