Abstract
Objective: Antenatal administration of magnesium sulphate (MgSO4) is recommended worldwide for imminent preterm birth due to its proven protective effect on Cerebral Palsy (CP). The aim of this study was to identify predictive factors for (suspect) CP, for neonates born between 24 and 32 weeks’ gestation, who are dismissed from the Neonatal Intensive Care Unit (NICU).
Methods: Cohort study of neonates born between 2012 and 2018 in Ghent University Hospital at a gestational age between 24 and 32 weeks. Predictive and risk factors for (suspect) CP described in literature were examined through modelling using generalized estimating equations.
Results: The study population consisted of 474 neonates, of which 293 were antenatally exposed to MgSO4. The composite outcome (suspect CP or CP) was present in 44 (9.3%) neonates. The final model consisted of the following variables: neuroprotection (odds ratio (OR): 0.38 (95% confidence interval (CI): 0.19, 0.75); p = 0.005), periventricular leukomalacia (OR: 2.41 (95%CI: 1.20, 4.82); p = 0.013), smoking (OR: 2.57 (95%CI: 1.21, 5.44); p = 0.014) and reason of preterm delivery (placental insufficiency versus SPL (OR: 0.34 (95%CI: 0.11, 1.08); p = 0.068), PPROM versus SPL (OR: 1, 23 (95%CI: 0.60, 2.52); p = 0.567) and other causes of preterm delivery versus SPL (OR: 0.70 (95%CI: 0.17, 2.99); p = 0.633)).
Conclusion: Neuroprotection is shown to be a protective factor. Periventricular leukomalacia and smoking are negatively associated with CP.