Abstract
INTRODUCTION: Preterm infants are at great risk of neurological impairments. This study aimed to evaluate what is the difference in short- and long-term neonatal outcome comparing magnesium sulphate in small dose (4 g) versus controls. METHODS: Prospective cohort study was conducted in the Department of Obstetrics and Gynaecology over a period of 4 years. Group A comprised of the study group (intravenous 4 g magnesium sulphate was given over 20 min). Group B consisted of control group who did not receive magnesium sulphate. RESULTS: The study population comprised of 116 pregnant women who received intravenous bolus of 4 grams MgSO4 while the control group comprised of 95 pregnant women who did not receive MgSO4. Fewer neonates in the MgSO4 group required intubation at birth (32% vs. 52%) or chest compression (4% vs. 6%); however, the difference was not statistically significantly (p = 0.175 and p = 0.329). Neonatal brain ultrasound done in first month showed a significant reduction intraventricular haemorrhage of severe grade 3-4 IVH in the MgSO4 group (p = 0.016). MgSO4 administration was associated with a decrease in neonatal mortality before discharge (p = 0.039). Follow-up at 3 years showed a significant reduction in delayed milestones, visual impairment, Bayley score < 85 (p = 0.015). MgSO4 treatment antenatally was associated with lower risk of Cerebral Palsy (2.6% vs. 23.2%, p < 0.001). CONCLUSION: The benefits from single smaller dose magnesium sulphate 4 gram prove its potential to be used for foetal neuroprotection in any healthcare setting without any maternal concerns.