Abstract

Objective: To assess the effect of postnatal magnesium sulphate in a large cohort of asphyxiated babies.
Methods: Ethical approval for this cross sectional survey of cases of perinatal asphyxia over a 19-month period was obtained. Cases were staged for Hypoxic Ischemic Encephalopathy. They were treated with daily infusion of magnesium sulphate at 250 mg per kilogram per dose daily for three doses. Pre-treatment era perinatal asphyxia, historical controls, 2009 to 2014, were comparison group. Other co-morbidities were also treated. Demographic, antepartum, perinatal antecedents and clinical information were noted. Data were analysed as frequencies, chi square using IBM SPSS Statistics 20. The level of significance, p value was set at <0.05.
Results: There were 915 admissions: 51.8% inborn and 2582 deliveries over the study period. 100 PA babies were treated: 52 inborn babies and 48 referred cases. The incidence of PA & HIE was 20.1 & 13.7 per 1000 live births for inborn. Postnatal MgSO₄ survival was 83% with 85% reduction in mortality. The comparison group were 611/4048 (14.96%). 174 of these (28.5%) died; 414 had HIE and 28.3% died. The significant contributors to survival of babies treated with MgSO₄ were observed in the Hypoxic Ischemic Encephalopathy II & III (p= 0.027). There was use of respiratory support in 78.33% of MgSO₄ treated cases who survived (p=0.001). There was a significant difference in survival between the comparison and MgSO₄ treated group.
Conclusions: Postnatal magnesium alone or combined with respiratory support improves survival of asphyxiated babies and babies with encephalopathy.