Antenatal magnesium sulfate is beneficial or harmful in very preterm and extremely preterm neonates: a new insight

Aims: To evaluate whether antenatal MgSO4 is beneficial or harmful in very preterm and extremely preterm neonates. Materials and methods: We retrieved published literature through searches of PubMed or Medline, CINAHL, and the Cochrane Library. Results were restricted to systematic reviews, meta-analysis, randomized controlled trials (RCTs), and relevant observational studies. Results: Evidence revealed that antenatal MgSO4 has neuroprotective role in preterm neonates and it decreased the risk of cerebral palsy and gross motor dysfunction. Evidences regarding association of antenatal MgSO4 with feed intolerance, NEC and SIP were from cohort studies and controversial. Conclusions: We should continue use antenatal MgSO4 to all eligible patients according to protocol till the more robust evidence will suggest association with gastrointestinal complications. In the meantime, we should have a high index of suspicion of gastrointestinal complications in extremely preterms particularly <26 weeks of gestation.