TOPLINE

Delivery within 12 hours after discontinuing maternal magnesium sulfate (MgSO4) was associated with more than seven times higher odds of apnea of prematurity (AOP) in late-preterm twin infants, whereas longer discontinuation intervals showed no such association. Maternal MgSO4 exposure itself was not independently linked to AOP risk.

METHODOLOGY

• Researchers conducted a retrospective cohort study at Yamanashi Prefectural Central Hospital in Japan and assessed 161 twin pregnancies (322 infants) delivered at 34 0/7 to 36 6/7 weeks' gestation from 2017 to 2025.
• Infants with major congenital anomalies or intrauterine fetal demise were excluded.
• The primary exposure was maternal MgSO4 exposure, categorized as no exposure or discontinuation < 12 hours, 12-24 hours, and ≥ 24 hours before delivery.
• Study outcome was AOP.
• Multivariable logistic regression analyses were adjusted for gestational age, chorionicity, small-for-gestational-age status, sex, and 1-minute Apgar score.

TAKEAWAY

• Overall, 34.8% of infants developed AOP during the study period.
• Maternal MgSO4 exposure alone was not significantly associated with risk for AOP.
• Delivery within 12 hours after MgSO4 cessation was independently associated with increased risk for AOP (adjusted odds ratio [aOR], 7.44; 95% CI, 1.48-37.4).
• Longer discontinuation intervals of 12-24 hours and ≥ 24 hours were not significantly associated with risk for AOP.

IN PRACTICE

"In conclusion, although confirmation in prospective cohorts is warranted, our findings suggest that delivery soon after maternal MgSO4 discontinuation may be associated with an increased incidence of AOP in late-preterm twin neonates," the authors of the study wrote. "Consideration of MgSO4 discontinuation timing in perinatal risk stratification may help identify infants who could benefit from closer respiratory monitoring."

SOURCE

The study was led by Satoshi Shinohara, Department of Obstetrics and Gynecology, Yamanashi Prefectural Central Hospital, Kofu, Japan. It was published online on July 27 in Pediatric Pulmonology.

LIMITATIONS

The retrospective single-center design limits generalizability. The study could not account for unmeasured confounders such as maternal comorbidities, labor duration, or neonatal magnesium levels. The relatively small sample size in some exposure categories, particularly the < 12-hour group, limited statistical power to detect associations.

DISCLOSURES

The study did not receive any specific funding. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.