dc.contributor.author |
Ufkes, Steven |
|
dc.contributor.author |
Kennedy, Eleanor |
|
dc.contributor.author |
Poppe, Tanya |
|
dc.contributor.author |
Miller, Steven P |
|
dc.contributor.author |
Thompson, Benjamin |
|
dc.contributor.author |
Guo, Jessie |
|
dc.contributor.author |
Harding, Jane E |
|
dc.contributor.author |
Crowther, Caroline A |
|
dc.coverage.spatial |
United States |
|
dc.date.accessioned |
2024-07-09T02:28:44Z |
|
dc.date.available |
2024-07-09T02:28:44Z |
|
dc.date.issued |
2024-05-01 |
|
dc.identifier.citation |
(2024). JAMA network open, 7(5), e2413508-. |
|
dc.identifier.issn |
2574-3805 |
|
dc.identifier.uri |
https://hdl.handle.net/2292/69008 |
|
dc.description.abstract |
IMPORTANCE: Understanding the effect of antenatal magnesium sulfate (MgSO4) treatment on functional connectivity will help elucidate the mechanism by which it reduces the risk of cerebral palsy and death. OBJECTIVE: To determine whether MgSO4 administered to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks is associated with increased functional connectivity and measures of functional segregation and integration in infants at term-equivalent age, possibly reflecting a protective mechanism of MgSO4. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was nested within a randomized placebo-controlled trial performed across 24 tertiary maternity hospitals. Participants included infants born to women at risk of imminent preterm birth at a gestational age between 30 and 34 weeks who participated in the MAGENTA (Magnesium Sulphate at 30 to 34 Weeks' Gestational Age) trial and underwent magnetic resonance imaging (MRI) at term-equivalent age. Ineligibility criteria included illness precluding MRI, congenital or genetic disorders likely to affect brain structure, and living more than 1 hour from the MRI center. One hundred and fourteen of 159 eligible infants were excluded due to incomplete or motion-corrupted MRI. Recruitment occurred between October 22, 2014, and October 25, 2017. Participants were followed up to 2 years of age. Analysis was performed from February 1, 2021, to February 27, 2024. Observers were blind to patient groupings during data collection and processing. EXPOSURES: Women received 4 g of MgSO4 or isotonic sodium chloride solution given intravenously over 30 minutes. MAIN OUTCOMES AND MEASURES: Prior to data collection, it was hypothesized that infants who were exposed to MgSO4 would show enhanced functional connectivity compared with infants who were not exposed. RESULTS: A total of 45 infants were included in the analysis: 24 receiving MgSO4 treatment and 21 receiving placebo; 23 (51.1%) were female and 22 (48.9%) were male; and the median gestational age at scan was 40.0 (IQR, 39.1-41.1) weeks. Treatment with MgSO4 was associated with greater voxelwise functional connectivity in the temporal and occipital lobes and deep gray matter structures and with significantly greater clustering coefficients (Hedge g, 0.47 [95% CI, -0.13 to 1.07]), transitivity (Hedge g, 0.51 [95% CI, -0.10 to 1.11]), local efficiency (Hedge g, 0.40 [95% CI, -0.20 to 0.99]), and global efficiency (Hedge g, 0.31 [95% CI, -0.29 to 0.90]), representing enhanced functional segregation and integration. CONCLUSIONS AND RELEVANCE: In this cohort study, infants exposed to MgSO4 had greater voxelwise functional connectivity and functional segregation, consistent with increased brain maturation. Enhanced functional connectivity is a possible mechanism by which MgSO4 protects against cerebral palsy and death. |
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dc.language |
eng |
|
dc.publisher |
American Medical Association (AMA) |
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dc.relation.ispartofseries |
JAMA Netw Open |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.rights.uri |
https://jamanetwork.com/pages/cc-by-license-permissions |
|
dc.subject |
Humans |
|
dc.subject |
Magnesium Sulfate |
|
dc.subject |
Female |
|
dc.subject |
Pregnancy |
|
dc.subject |
Infant, Newborn |
|
dc.subject |
Magnetic Resonance Imaging |
|
dc.subject |
Male |
|
dc.subject |
Adult |
|
dc.subject |
Gestational Age |
|
dc.subject |
Cohort Studies |
|
dc.subject |
Premature Birth |
|
dc.subject |
Infant |
|
dc.subject |
Brain |
|
dc.subject |
Prenatal Care |
|
dc.subject |
Cerebral Palsy |
|
dc.subject |
3213 Paediatrics |
|
dc.subject |
3215 Reproductive Medicine |
|
dc.subject |
32 Biomedical and Clinical Sciences |
|
dc.subject |
Infant Mortality |
|
dc.subject |
Clinical Trials and Supportive Activities |
|
dc.subject |
Preterm, Low Birth Weight and Health of the Newborn |
|
dc.subject |
Clinical Research |
|
dc.subject |
Prevention |
|
dc.subject |
Neurosciences |
|
dc.subject |
Brain Disorders |
|
dc.subject |
Pediatric |
|
dc.subject |
Biomedical Imaging |
|
dc.subject |
Perinatal Period - Conditions Originating in Perinatal Period |
|
dc.subject |
6.1 Pharmaceuticals |
|
dc.subject |
6 Evaluation of treatments and therapeutic interventions |
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dc.subject |
Reproductive health and childbirth |
|
dc.subject |
42 Health sciences |
|
dc.title |
Prenatal Magnesium Sulfate and Functional Connectivity in Offspring at Term-Equivalent Age |
|
dc.type |
Journal Article |
|
dc.identifier.doi |
10.1001/jamanetworkopen.2024.13508 |
|
pubs.issue |
5 |
|
pubs.begin-page |
e2413508 |
|
pubs.volume |
7 |
|
dc.date.updated |
2024-06-05T10:36:18Z |
|
dc.rights.holder |
Copyright: The authors |
en |
pubs.author-url |
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819063 |
|
pubs.publication-status |
Published online |
|
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Journal Article |
|
pubs.subtype |
Randomized Controlled Trial |
|
pubs.elements-id |
1029990 |
|
pubs.org-id |
Liggins Institute |
|
pubs.org-id |
LiFePATH |
|
dc.identifier.eissn |
2574-3805 |
|
dc.identifier.pii |
2819063 |
|
pubs.record-created-at-source-date |
2024-06-05 |
|
pubs.online-publication-date |
2024-05-28 |
|