Changing Tocolytic Exposures among Neonatal Intensive Care Unit Admitted Preterm Infants.

Am J Perinatol

Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas.

Published: December 2022

Objective: Since 2010, the American College of Obstetrics and Gynecology have released three committee opinions to recommend and reaffirm the utility of magnesium sulfate for neuroprotection and later for tocolysis to achieve antenatal steroid course completion in preterm labor. We sought to determine changes in antenatal magnesium sulfate exposure and other tocolytic agents for pregnancies resulting in neonatal intensive care unit (NICU)-admitted preterm infants.

Study Design: Using the Pediatrix Clinical Data Warehouse, we evaluated all inborn infants delivered between 22 and 33 weeks' gestation and admitted to the intensive care units from 2009 to 2018. We classified patients based on antenatal exposure to tocolytic medications: calcium channel blockers (nifedipine and amlodipine), betamimetics (terbutaline, theophylline, and ritodrine), prostaglandin inhibitors (indomethacin), and magnesium sulfate.

Results: A total of 229,781 patients met inclusion criteria. During the study period, magnesium sulfate exposure increased from 27.6 to 57.7% of births while betamimetic exposure decreased from 10.2 to 5.2%. Increasing magnesium sulfate exposure over time was seen at all gestational ages examined and magnesium exposure was most common between 23 and 31 weeks' gestation. By 2017 to 2018, 70.5% of 24 to 29 weeks' gestation NICU infants received exposure to at least one tocolytic agent while this remained at 53.7% of 32 to 33 weeks' NICU admitted infants. Antenatal steroid exposure increased from 74.8 to 87.4% during the study period.

Conclusion: For NICU-admitted preterm infants, prenatal exposure patterns to tocolytic agents has shifted since 2009 with prenatal magnesium sulfate exposure increasing significantly. Antenatal steroid exposure has risen concurrently. Exposure to tocolytic agents is the highest among preterm infants born between 24 and 29 weeks' gestation.

Key Points: · Exposure to magnesium sulfate significantly increased from 2009 to 2018 for NICU admitted infants.. · Concurrently, the use of other tocolytics decreased significantly.. · The use of antenatal steroids has been rising over time..

Download full-text PDF

Source
http://dx.doi.org/10.1055/a-1745-3262DOI Listing

Publication Analysis

Top Keywords

magnesium sulfate
24
sulfate exposure
16
exposure tocolytic
16
exposure
13
intensive care
12
preterm infants
12
antenatal steroid
12
tocolytic agents
12
weeks' gestation
12
neonatal intensive
8

Similar Publications

A Retrospective Review of Children Admitted With Acute Severe Asthma to the Paediatric Intensive Care Unit, Red Cross War Memorial Children's Hospital Between 2009 and 2019.

J Paediatr Child Health

January 2025

Paediatric Intensive Care Unit, Red Cross War Memorial Children's Hospital, Senior Lecturer, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.

Aim: There is limited data on the PICU outcomes of children with acute severe asthma (ASA) in South Africa. This study aims to describe the profiles and treatment of all children admitted to our PICU with ASA.

Methods: A retrospective audit of all children admitted with ASA to the PICU at Red Cross War Memorial Children's Hospital between 01 January 2009 and 31 December 2019.

View Article and Find Full Text PDF

A wound, defined as a disruption in the continuity of the skin, is among the most common issues in the population and poses a significant burden on healthcare systems and economies worldwide. Despite the countless medical devices currently available to promote wound repair and skin regeneration, there is a growing demand for new skin devices that incorporate innovative biomaterials and advanced technologies. Bioglasses are biocompatible and bioactive materials capable of interacting with biological tissues.

View Article and Find Full Text PDF

Soil contamination with toxic heavy metals [such as aluminum (Al)] is becoming a serious global problem due to the rapid development of the social economy. Although plant growth-promoting rhizo-bacteria (PGPR) are the major protectants to alleviate metal toxicity, the study of these bacteria to ameliorate the toxic effects of Al is limited. Therefore, the present study was conducted to investigate the combined effects of different levels of (5 ppm and 10 ppm) of accession number of MT123456 on plant growth and biomass, photosynthetic pigments, gas exchange attributes, oxidative stress and response of antioxidant compounds (enzymatic and nonenzymatic), and their specific gene expression, sugars, nutritional status of the plant, organic acid exudation pattern and Al accumulation from the different parts of the plants, which was spiked with different levels of Al [0 µM (i.

View Article and Find Full Text PDF

Venous thromboembolic disease remains a leading cause of maternal morbidity and mortality. We report a case of a 30-year-old woman at 37 gestation with a history of thalassaemia intermedia and splenectomy. During pregnancy, she had been managed with frequent blood transfusions and enoxaparin.

View Article and Find Full Text PDF

Objective: To evaluate the efficacy and safety of magnesium sulfate in the treatment of acute severe asthma in adults.

Methods: Literature searches were conducted on PubMed, Cochrane, CNKI, VIP and Wanfang databases to screen randomized controlled trial (RCT) of magnesium sulfate in the treatment of acute severe asthma in adults, starting from the establishment of the database and ending on May 22, 2024. The control group received conventional treatment.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!