Beneficial Effect of Intravenous Magnesium Sulphate in Term Neonates with Perinatal Asphyxia

Authors

  • Khuzaima Shakir Pediatric Department, Jinnah Hospital, Lahore, Pakistan
  • Ayesha Arif Pediatric Department, Jinnah Hospital, Lahore, Pakistan
  • Noor Maryam Pediatric Department, Jinnah Hospital, Lahore, Pakistan
  • Awais Tariq Pediatric Department, Jinnah Hospital, Lahore, Pakistan
  • Muhammad Irfan Jamil Department of Nephrology, Lahore General Hospital, Lahore, Pakistan
  • Muhammad Arslan Pediatric Department, Jinnah Hospital, Lahore, Pakistan
  • Mohammad Imran Younus Department of Public Health, Health Services Academy, Islamabad, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i7.1863

Keywords:

Hypoxic ischemic encephalopathy, term neonates, magnesium sulphate, neurological outcomes, neonatal mortality

Abstract

Background: Hypoxic ischemic encephalopathy (HIE) is a significant contributor to neonatal morbidity and mortality. This study evaluated the clinical impact of intravenous magnesium sulphate in term neonates with HIE. Methods: A descriptive case series was conducted at the Department of Pediatrics, Jinnah Hospital Lahore, from March 1, 2025 to June 01, 2025. One hundred thirty-eight term neonates meeting diagnostic and severity criteria for HIE were enrolled. Severity was assessed using the Thomson score. All neonates received standard intensive care and intravenous magnesium sulphate at 250 mg/kg over 30 minutes on admission, with repeat doses at 24 and 48 hours. Outcomes were monitored over a 7-day period, including return to normal neurological status, seizure occurrence, establishment of suck feeding, and mortality. Data were analyzed using SPSS version 22. Results: The mean gestational age was 38.4 ± 1.1 weeks, with a mean birth weight of 2985 ± 355 grams. Of the 138 neonates, 82 (59.4%) were male and 56 (40.6%) were female; 44 (31.9%) had HIE grade I, 70 (50.7%) grade II, and 24 (17.4%) grade III. Following therapy, the mean Thomson score decreased from 13.1 ± 2.9 to 1.5 ± 1.2 by day 7. Return to normal neurological status was documented in 101 (73.2%) neonates. Seizure activity occurred in 36 (26.1%). The ability to establish effective suck feeding by day 7 was achieved in 110 (79.7%) neonates. Mortality within seven days was observed in 12 (8.7%) cases. Conclusion: The addition of intravenous magnesium sulphate to standard management was associated with substantial neurological recovery, improved feeding outcomes, and low short-term mortality in term neonates with HIE.

Downloads

Download data is not yet available.

References

1. Greco P, Nencini G, Piva I, et al.: Pathophysiology of hypoxic–ischemic encephalopathy: a review of the past and a view on the future. Acta Neurol Belg. 2020, 120:277–88.

https://doi.org/10.1007/s13760-020-01308-3

2. Michniewicz B, Al Saad SR, Karbowski LM, Gadzinowski J, Szymankiewicz M, Szpecht D: Organ Complications of Infants with Hypoxic Ischemic Encephalopathy before. Ther Hypothermia Temp Manag. 2021, 11:58–63.

https://doi.org/10.1089/ther.2020.0035

3. Workineh Y, Semachew A, Ayalew E, Animaw W, Tirfie M, Birhanu M: Prevalence of perinatal asphyxia in East and Central Africa: systematic review and meta-analysis. Heliyon. 2020, 6:.

https://doi.org/10.1016/j.heliyon.2020.e03793

4. Molloy EJ, El-Dib M, Juul SE, et al.: Neuroprotective therapies in the NICU in term infants: present and future. Pediatr Res. 2023, 93:1819–27.

https://doi.org/10.1038/s41390-022-02295-2

5. Molloy EJ, El-Dib M, Soul J, et al.: Neuroprotective therapies in the NICU in preterm infants: present and future (Neonatal Neurocritical Care Series). Pediatr Res. 2024, 95:1224–36.

https://doi.org/10.1038/s41390-023-02895-6

6. Khan Sajid N, Junaid M, Ahmed S, Al Habib Hospital Buriyadah S, Qasime Saudi Arabia A: Therapeutic Efficacy of Magnesium Sulphate on Neurological Outcome of Neonates With Severe Birth Asphyxia. J Univ Med Dent Coll. 2018, 9:1–5.

7. D’Angelo G, Cannavò L, Reiter RJ, Gitto E: Melatonin Administration from 2000 to 2020 to Human Newborns with Hypoxic-Ischemic Encephalopathy. Am J Perinatol. 2022, 39:824–9.

https://doi.org/10.1055/s-0040-1719151

8. Galinsky R, Dean JM, Lingam I, Robertson NJ, Mallard C, Bennet L, Gunn AJ: A systematic review of magnesium sulfate for perinatal neuroprotection: What have we learnt from the past decade? Front Neurol. 2020, 11:1–14.

https://doi.org/10.3389/fneur.2020.00449

9. Nanda AK, Jalan A, Pradhan SK, Kumar TVR, Pradhan PC: Effect of magnesium sulphate infusion on neonatal outcomes in babies with perinatal asphyxia. Int J Health Sci (Qassim). 2022, 6:13064–75.

https://doi.org/10.53730/ijhs.v6ns2.8450

10. Panda S, Nayak H, Kiro S, Hembram P, Nayak U, Pande B, Sahoo S: Intravenous Magnesium Sulphate In Perinatal Asphyxia: An Open Labelled Trial. Int J Life Sci. 2023, 12:1648–53.

11. Siddiqui MAS, Butt TK: Role of intravenous magnesium sulphate in term neonates with hypoxic ischemic encephalopathy (hie) in a low-income country: A randomised clinical trial. J Coll Physicians Surg Pakistan. 2021, 31:817–20.

https://doi.org/10.29271/jcpsp.2021.07.817

12. Bhat MA, Charoo BA, Bhat JI, Ahmad SM, Ali SW, Mufti MUH: Magnesium sulfate in severe perinatal asphyxia: A randomized, placebo-controlled trial. Obstet Gynecol Surv. 2009, 64:573–4.

https://doi.org/10.1097/01.ogx.0000358028.38402.ff

13. Ichiba H, Yokoi T, Tamai H, Ueda T, Kim TJ, Yamano T: Neurodevelopmental outcome of infants with birth asphyxia treated with magnesium sulfate. Pediatr Int. 2006, 48:70–5.

https://doi.org/10.1111/j.1442-200X.2006.02167.x

14. R. S, Rajprakash R: Beneficial effect of intravenous magnesium sulphate in term neonates with perinatal asphyxia. Int J Contemp Pediatr. 2016, 3:150–4.

https://doi.org/10.18203/2349-3291.ijcp20160149

15. Aamina Ahmed, Aqeela Jabeen, Hina Sattar, Zainab Bibi: Role of Intravenous Magnesium Sulphate in Term Neonates with Severe Birth Asphyxia in Terms of Immediate Neurological Outcome. Indus J Biosci Res. 2025, 3:697–701.

https://doi.org/10.70749/ijbr.v3i4.990

16. Pius S, Bello M, Ambe JP, Machoko Y, Clement AY, Genesis R, Kamas MI: Pilot Study: Magnesium Sulphate Administration and Early Resolution of Hypoxic Ischemic Encephalopathy in Severe Perinatal Asphyxia. Open J Pediatr. 2019, 09:89–102.

https://doi.org/10.4236/ojped.2019.91009

17. Akram M, Malik AR, Ahmad M, Arshad RT: Enhancing Neonatal Sucking Reflex: A Study on the Efficacy of Magnesium Sulphate in Severe Birth Asphyxia. Pakistan J Heal Sci. 2025, 191–6.

https://doi.org/10.54393/pjhs.v6i1.1936

18. Sarda SP, Sarri G, Siffel C: Global prevalence of long-term neurodevelopmental impairment following extremely preterm birth: a systematic literature review. J Int Med Res. 2021, 49:3000605211028026.

https://doi.org/10.1177/03000605211028026

19. Rasheed J, Khalid M, Maryam B, Parveen S: Effect of Intravenous Magnesium Sulphate on in-Hospital Mortality in Neonates with Perinatal Asphyxia: A Prospective Cohort Study. Ann King Edward Med Univ. 2023, 29:136–41.

https://doi.org/10.21649/akemu.v29i2.5442

20. 20. Riaz L, Ahmed SM, Zakki MA, Faryad N, Iram S, Iqbal S: Comparison of Phenobarbital versus Magnesium Sulphate for Management of Neonate with Birth Asphyxia. Pakistan J Med Heal Sci. 2021, 15:2145–7.

https://doi.org/10.53350/pjmhs211582145

Downloads

Published

2025-07-15

How to Cite

Shakir, K., Arif, A., Maryam, N., Tariq, A., Jamil, M. I., Arslan, M., & Younus, M. I. (2025). Beneficial Effect of Intravenous Magnesium Sulphate in Term Neonates with Perinatal Asphyxia. Indus Journal of Bioscience Research, 3(7), 228-232. https://doi.org/10.70749/ijbr.v3i7.1863