Association between prenatal magnesium sulfate and neonatal respiratory depression: A Meta-analysis.

doi:10.3877/cma.j.issn.2095-3259.2016.04.012

Abstract

Abstract:

Objective

To analyze the association between prenatal magnesium sulfate and the neonatal respiratory depression.

Methods

Literatures about the association between prenatal magnesium sulfate and the neonatal respiratory depression were collected from multiple databases, including Pubmed, Cochrane Library, EMBASE, OVID, Wanfang database, CNKI and CBM. Relevant outcomes were analyzed by the Review Manager 5.3.5 software programs. The outcome indicators included respiratory distress syndrome, ventilator usage, 5-minute Apgar scores < 7 and pediatric mortality. They were assessed by relative risk (RR).

Results

Fourteen literatures were eligible, involving 10 877 cases in magnesium sulfate group and 13 246 cases in control group. Meta-analysis demonstrated the association between prenatal magnesium sulfate and the neonatal respiratory depression were no significant differences. The relative risk was 0.98 (95%CI: 0.91-1.05) of respiratory distress syndrome, 0.98 (0.92-1.05) of ventilator usage, 0.98 (0.91-1.05) of 5-minute Apgar scores <7 and 0.93 (0.82-1.06) of pediatric mortality, respectively.

Conclusion

This Meta-analysis suggests that the prenatal magnesium sulfate may not increase the risk of the neonatal respiratory depression.

Key words: Magnesium sulfate, Infant, newborn, Respiratory insufficiency, Meta-analysis

Chunyan Wang, Xiaoyan Wang, Lin Yu, Dunjin Chen. Association between prenatal magnesium sulfate and neonatal respiratory depression: A Meta-analysis.[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2016, 05(04): 244-248.

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Figures/Tables 3

References 23

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文献	时间(年月)	母亲年龄(岁，硫酸镁组/对照组)	分娩孕周(周，硫酸镁组/对照组)
Lloreda-Garcia等^[6]	2012.10～2015.03	32/29	29(27.5～31)/30(29～31)
Crowther等^[5]	1996.02～2000.09	28.4±5.8/28.7±5.8	<30
Rouse等^[7]	1997.12～2004.05	26.1±6.3/25.9±6.2	29.8±3.1/29.7±3.1
Altman等^[8]	1998.07～2001.11	27.1±6.7/27.2±6.7	<37
Mittendorf等^[9]	1995～1997	—	24－34
Marret等^[10]	1997.07～2003.07	29.3±5.3/29.5±5.1	30.1(24.1～32.9)/30.1(23.6～32.9)
Paradisis等^[11]	1996～2000	—	27.0±1.7/27.0±1.5
Rantonen等^[12]	1995～1998	32.4/31	<33
Magpie等^[13]	1998.07～2001.11	—	—
Gibbins等^[14]	2007.10～2011.02	28±6.7/27.6±6.4	<32
Bouet等^[15]	2011.09～2012.12	29.3±6.2/30.3±4.2	29.6±2.1/30.1±1.9
Gursoy等^[16]	2011.12～2013.04	—	31.2±1.8/30.9±1.9
Weisz等^[17]	2011.01～2012.12	—	28±2.3/28±2.3
James等^[18]	2013.02～2014.12	—	27.4(25.5～28.0)/27.8(26.1～28.5)

文献	时间(年月)	母亲年龄(岁，硫酸镁组/对照组)	分娩孕周(周，硫酸镁组/对照组)
Lloreda-Garcia等^[6]	2012.10～2015.03	32/29	29(27.5～31)/30(29～31)
Crowther等^[5]	1996.02～2000.09	28.4±5.8/28.7±5.8	<30
Rouse等^[7]	1997.12～2004.05	26.1±6.3/25.9±6.2	29.8±3.1/29.7±3.1
Altman等^[8]	1998.07～2001.11	27.1±6.7/27.2±6.7	<37
Mittendorf等^[9]	1995～1997	—	24－34
Marret等^[10]	1997.07～2003.07	29.3±5.3/29.5±5.1	30.1(24.1～32.9)/30.1(23.6～32.9)
Paradisis等^[11]	1996～2000	—	27.0±1.7/27.0±1.5
Rantonen等^[12]	1995～1998	32.4/31	<33
Magpie等^[13]	1998.07～2001.11	—	—
Gibbins等^[14]	2007.10～2011.02	28±6.7/27.6±6.4	<32
Bouet等^[15]	2011.09～2012.12	29.3±6.2/30.3±4.2	29.6±2.1/30.1±1.9
Gursoy等^[16]	2011.12～2013.04	—	31.2±1.8/30.9±1.9
Weisz等^[17]	2011.01～2012.12	—	28±2.3/28±2.3
James等^[18]	2013.02～2014.12	—	27.4(25.5～28.0)/27.8(26.1～28.5)

文献	硫酸镁使用方法
Lloreda-Garcia等^[6]	负荷剂量4 g，维持剂量1 g/h
Crowther等^[5]	负荷剂量4 g，20 min滴完，维持剂量1 g/h，24 h或直至分娩
Rouse等^[7]	负荷剂量6 g，20～30 min滴完，维持剂量2 g/h，12 h或直至分娩
Altman等^[8]	负荷剂量4 g，10～15 min滴完，维持剂量1 g/h或5 g/4 h，24 h
Mittendorf等^[9]	负荷剂量4 g，无维持剂量
Marret等^[10]	负荷剂量4 g，30 min滴完，无维持剂量
Paradisis等^[11]	负荷剂量4 g，20 min滴完，维持剂量2 g/h，24 h或直至分娩
Rantonen等^[12]	负荷剂量5 g，20 min滴完，维持剂量1 g/h，直至子宫停止收缩或母亲心率>140次/min
Magpie等^[13]	未见详细报导
Gibbins等^[14]	负荷剂量6 g，维持剂量2 g/h，直至分娩或评估不会立即分娩则停止
Bouet等^[15]	负荷剂量4 g，维持剂量1 g/h
Gursoy等^[16]	负荷剂量6 g，30 min滴完，维持剂量0.8 g/h，直至分娩
Weisz等^[17]	未见详细报道
James等^[18]	未见详细报道

文献	硫酸镁使用方法
Lloreda-Garcia等^[6]	负荷剂量4 g，维持剂量1 g/h
Crowther等^[5]	负荷剂量4 g，20 min滴完，维持剂量1 g/h，24 h或直至分娩
Rouse等^[7]	负荷剂量6 g，20～30 min滴完，维持剂量2 g/h，12 h或直至分娩
Altman等^[8]	负荷剂量4 g，10～15 min滴完，维持剂量1 g/h或5 g/4 h，24 h
Mittendorf等^[9]	负荷剂量4 g，无维持剂量
Marret等^[10]	负荷剂量4 g，30 min滴完，无维持剂量
Paradisis等^[11]	负荷剂量4 g，20 min滴完，维持剂量2 g/h，24 h或直至分娩
Rantonen等^[12]	负荷剂量5 g，20 min滴完，维持剂量1 g/h，直至子宫停止收缩或母亲心率>140次/min
Magpie等^[13]	未见详细报导
Gibbins等^[14]	负荷剂量6 g，维持剂量2 g/h，直至分娩或评估不会立即分娩则停止
Bouet等^[15]	负荷剂量4 g，维持剂量1 g/h
Gursoy等^[16]	负荷剂量6 g，30 min滴完，维持剂量0.8 g/h，直至分娩
Weisz等^[17]	未见详细报道
James等^[18]	未见详细报道

结局指标	异质性		效应量
结局指标	I²值	P值	RR	95%CI	P值
新生儿呼吸窘迫综合征	0%	0.43	0.98	(0.91～1.05)	0.51(>0.05)
通气设备使用	61%	0.01	0.98	(0.92～1.05)	0.56(>0.05)
5 min Apgar评分<7分	0%	0.50	0.98	(0.91～1.05)	0.54(>0.05)
围产儿死亡	37%	0.12	0.93	(0.82～1.06)	0.26(>0.05)

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