Use of magnesium sulfate before 32 weeks of gestation: a European population-based cohort study. Issue 1 (27th January 2017)

• Record Type: Journal Article
• Authors: Wolf, H T; Huusom, L; Weber, T; Piedvache, A; Schmidt, S; Norman, M; Zeitlin, J
• Other Names: author non-byline.; Martens E author non-byline.; Martens G author non-byline.; Van Reempts P author non-byline.; Boerch K author non-byline.; Hasselager A author non-byline.; Pryds O author non-byline.; Toome L author non-byline.; Varendi H author non-byline.; Ancel PY author non-byline.; Blondel B author non-byline.; Burguet A author non-byline.; Jarreau PH author non-byline.; Truffert P author non-byline.; Maier RF author non-byline.; Misselwitz B author non-byline.; Gortner L author non-byline.; Baronciani D author non-byline.; Gargano G author non-byline.; Agostino R author non-byline.; DiLallo D author non-byline.; Franco F author non-byline.; Carnielli V author non-byline.; Cuttini M author non-byline.; Koopman-Esseboom C author non-byline.; Van Heijst A author non-byline.; Nijman J author non-byline.; Gadzinowski J author non-byline.; Mazela J author non-byline.; Graça LM author non-byline.; Machado MC author non-byline.; Rodrigues C author non-byline.; Rodrigues T author non-byline.; Barros H author non-byline.; Bonamy AK author non-byline.; Wilson E author non-byline.; Boyle E author non-byline.; Draper ES author non-byline.; Manktelow BN author non-byline.; Fenton AC author non-byline.; Milligan DWA author non-byline.; Bonet M author non-byline.;
• Is Part Of: BMJ open. Volume 7:Issue 1(2017)
• Publication Date: 2017-01-27
• Subjects: PREVENTIVE MEDICINE; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2016-013952
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: The use of magnesium sulfate (MgSO4 ) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. Methods: We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires. The study population comprised 720 women with severe pre-eclampsia, eclampsia or HELLP and 3658 without pre-eclampsia delivering from 24 to 31 weeks of gestation in 119 maternity units with 20 or more very preterm deliveries per year. Results: Among women with severe pre-eclampsia, eclampsia or HELLP, 255 (35.4%) received MgSO4 before delivery. 41% of units reported use of MgSO4 whenever possible for pre-eclampsia and administered MgSO4 more often than units reporting use sometimes. In women without pre-eclampsia, 95 (2.6%) received MgSO4 . 9 units (7.6%) reported using MgSO4 for fetal neuroprotection whenever possible. In these units, the median rate of MgSO4 use for deliveries without severe pre-eclampsia, eclampsia and HELLP was 14.3%. Only 1 unit reported using MgSO4 as a first-line tocolytic. Among women without pre-eclampsia, MgSO4 use was not higher in women hospitalised before delivery for preterm labour. Conclusions: Severe pre-eclampsia, eclampsia or HELLP are not treated with MgSO4 as frequently as evidence-based medicine recommends. MgSO4 is seldom used for fetal neuroprotection, and is no longer used for tocolysis. To continuously lower morbidity, greater attention to use of MgSO4 is needed.