Admin_Adham
TOPLINE
Among patients receiving magnesium sulfate for fetal neuroprotection, only 23% delivered within 24 hours of initial administration, with a median interval of nearly 8 days. When repeat administrations during the same hospitalization were considered, more than half delivered within 24 hours of any treatment course.
METHODOLOGY
- Researchers conducted a multicenter retrospective cohort study across seven hospitals within a large academic health system in the US between January 1, 2019, and December 31, 2021, including 692 patients who received magnesium sulfate for neuroprotection between 23 and 31 weeks’ gestation.
- Primary outcomes were the proportion of women delivering within 24 hours of initial magnesium sulfate administration and the latency from treatment to delivery.
- Secondary outcomes included the proportion delivering within 24 hours of any magnesium sulfate administration when subsequent administrations during the same hospitalization were considered, and the odds of discharge home undelivered according to clinical indication.
- Statistical analysis included the χ2 test or Mann-Whitney U test, with statistical significance defined as P < .05, and multivariable logistic regression was used to estimate adjusted odds ratios.
TAKEAWAY
- Only 23.1% of patients receiving magnesium sulfate for fetal neuroprotection delivered within 24 hours of initial administration, with a median interval from initial treatment to delivery of 7.9 days.
- When subsequent administrations were considered, 53.6% of patients delivered within 24 hours of any treatment course, with an additional 30.5% of the overall cohort delivering within 24 hours of a repeated course.
- Preterm labor with intact membranes was associated with higher odds of discharge undelivered (adjusted odds ratio [AOR], 3.62; 95% CI, 2.25-5.84), as was vaginal bleeding (AOR, 2.08; 95% CI, 1.03-4.19).
- Nonreassuring fetal status was associated with lower odds of discharge undelivered, although the association was not statistically significant (AOR, 0.22; 95% CI, 0.05-1.02).
IN PRACTICE
“Latency varied according to the clinical indication for neuroprotection. These findings quantify how often an initial assessment of imminent preterm delivery is not followed by delivery within the anticipated treatment window and help explain why repeat administration is common during prolonged hospitalization,” the authors of the study wrote.
SOURCE
The study was led by Natav Hendin, Division of Maternal Fetal Medicine, Department of Ob/Gyn, Lenox Hill Hospital, Northwell Health, New York City. It was published online in American Journal of Obstetrics and Gynecology.
LIMITATIONS
The study is limited by its retrospective cohort design, which may introduce selection bias and confounding variables not accounted for in the analysis. The study was conducted across seven hospitals within a single large academic health system, which may limit the generalizability of findings to other healthcare settings with different patient populations or clinical practices. The study did not evaluate neonatal outcomes or the effectiveness of magnesium sulfate for neuroprotection, focusing solely on timing and delivery latency. Additionally, the study period was limited to 3 years (2019-2021), some during the COVID pandemic, which may not capture longer-term trends or variations in clinical practice.
DISCLOSURES
No disclosures or conflict of interest statements are provided in the study.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
