Effect of magnesium sulphate infusion on neonatal outcomes in babies with perinatal asphyxia: A randomized controlled trial

Introduction- With a relatively scant evidence base in Indian population, this study aimed to determine the efficacy of intravenous magnesium sulphate in neonates with moderate to severe perinatal asphyxia on the severity of seizures, number of anticonvulsants used, duration of hospitalization and feeding pattern at discharge. Methodology- This was a non-blinded randomized controlled trial that was conducted among 227 neonates admitted to the SNCU of MKCG Medical College Hospital. Randomization and allocation of eligible neonates was done using software. The intervention used was magnesium sulfate given intravenously by trained pediatricians in a loading dose of 250 mg/kg/dose, given over 1 hour in 20 ml of 5% dextrose solution. This was given at the time of admission followed by two infusions of the same dosage after 24 and 48 hours of the first dose. Outcomes on neonatal feeding, survival, need for medications and seizure management were recorded and analysed using an intention to treat protocol. Results- The distribution of most clinico-social parameters were comparable between the 2 groups. The babies who received MgSO4 within 6 hours of life achieved earlier initiation of feeds (32 hours) as compared to control groups (63 hrs). They also reached full feeding significantly earlier