Magnesium useful for newborns with low oxygen
Early treatment with magnesium can reduce the nerve damage seen in infants with low oxygen levels, also referred to as asphyxia at birth.
Early treatment with magnesium can reduce the nerve damage seen in infants with low oxygen levels, also referred to as asphyxia at birth.
Perinatal asphyxia occurs when a newborn is deprived of oxygen long enough to cause apparent damage. Most commonly, it is due to a fall in the mother's blood pressure or interference during delivery with blood flow to the infant's brain. Between 2 and 10 infants per 1000 born at full-term have perinatal asphyxia.
Asphyxia causes high levels of the amino acid glutamate to build up in the newborn brain. For up to 72 hours, the excess glutamate causes irreversible nerve injury by opening certain cell channels and allowing calcium to flow into cells. Magnesium works to block this calcium inflow.
To learn whether magnesium can reduce the extent of nerve damage in children born with asphyxia, researches from India studied 40 term infants admitted to their neonatal intensive care unit with severe perinatal asphyxia and moderate or severe brain injury. They were randomly assigned to receive either three magnesium treatments or inactive placebo.
Both groups received their assigned treatment within six hours of birth, then again after 24 and 48 hours. The infants also received normal supportive care for perinatal asphyxia. Two infants in each group died during hospitalisation.
Fifty-six percent of patients given placebo had abnormal neurologic exams when discharged from the hospital compared with just 22 percent of those given magnesium.
The study was the first human trial in which the role of magnesium sulfate in neonates with perinatal asphyxia was compared to a placebo. However, two patients on magnesium developed temporary breathing loss, highlighting that adverse effects can occur during magnesium infusion and hence, intense monitoring is needed.
Though this study shows that early institution of magnesium sulfate infusion is effective and beneficial in improving outcomes for infants with severe perinatal asphyxia, more studies with larger sample sizes and conducted at multiple centers are needed to confirm the results.
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