{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T01:12:57Z","timestamp":1752282777615,"version":"3.37.3"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>\n            Objective\u2003Since 2010, the American College of Obstetrics and Gynecology have released three committee opinions to recommend and reaffirm the utility of magnesium sulfate for neuroprotection and later for tocolysis to achieve antenatal steroid course completion in preterm labor. We sought to determine changes in antenatal magnesium sulfate exposure and other tocolytic agents for pregnancies resulting in neonatal intensive care unit (NICU)-admitted preterm infants.<\/jats:p><jats:p>\n            Study Design\u2003Using the Pediatrix Clinical Data Warehouse, we evaluated all inborn infants delivered between 22 and 33 weeks' gestation and admitted to the intensive care units from 2009 to 2018. We classified patients based on antenatal exposure to tocolytic medications: calcium channel blockers (nifedipine and amlodipine), betamimetics (terbutaline, theophylline, and ritodrine), prostaglandin inhibitors (indomethacin), and magnesium sulfate.<\/jats:p><jats:p>\n            Results\u2003A total of 229,781 patients met inclusion criteria. During the study period, magnesium sulfate exposure increased from 27.6 to 57.7% of births while betamimetic exposure decreased from 10.2 to 5.2%. Increasing magnesium sulfate exposure over time was seen at all gestational ages examined and magnesium exposure was most common between 23 and 31 weeks' gestation. By 2017 to 2018, 70.5% of 24 to 29 weeks' gestation NICU infants received exposure to at least one tocolytic agent while this remained at 53.7% of 32 to 33 weeks' NICU admitted infants. Antenatal steroid exposure increased from 74.8 to 87.4% during the study period.<\/jats:p><jats:p>\n            Conclusion\u2003For NICU-admitted preterm infants, prenatal exposure patterns to tocolytic agents has shifted since 2009 with prenatal magnesium sulfate exposure increasing significantly. Antenatal steroid exposure has risen concurrently. Exposure to tocolytic agents is the highest among preterm infants born between 24 and 29 weeks' gestation.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1745-3262","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T23:37:46Z","timestamp":1642635466000},"page":"1745-1749","source":"Crossref","is-referenced-by-count":1,"title":["Changing Tocolytic Exposures among Neonatal Intensive Care Unit Admitted Preterm Infants"],"prefix":"10.1055","volume":"39","author":[{"given":"Meghan L.","family":"Jarman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica M.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Research Analytics and Development Cores, Baylor Scott and White Research Institute, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judette M.","family":"Louis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reese H.","family":"Clark","sequence":"additional","affiliation":[{"name":"MEDNAX Center for Research Education, Quality, and Safety, Sunrise, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veeral N.","family":"Tolia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Baylor University Medical Center, Dallas, Texas"},{"name":"Pediatrix Medical Group, Dallas, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5970-6791","authenticated-orcid":false,"given":"Kaashif A.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas"},{"name":"MEDNAX Center for Research Education, Quality, and Safety, Sunrise, Florida"},{"name":"Pediatrix Medical Group of San Antonio, San Antonio, Texas"},{"name":"Department of Pediatrics, Baylor College of Medicine, San Antonio, Texas"},{"name":"Pediatrix and Obstetrix Specialists of Houston, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(08)60074-4","article-title":"Epidemiology and causes of preterm birth","volume":"371","author":"R L Goldenberg","year":"2008","journal-title":"Lancet"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1097\/AOG.0b013e3181d4ffa5","article-title":"Committee opinion no. 455: magnesium sulfate before anticipated preterm birth for neuroprotection","volume":"115","author":"Committee Opinion 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Med"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/jama.281.1.46","article-title":"Methods to encourage the use of antenatal corticosteroid therapy for fetal maturation: a randomized controlled trial","volume":"281","author":"L C Leviton","year":"1999","journal-title":"JAMA"},{"issue":"11","key":"ref11","first-page":"CD000025","article-title":"Magnesium sulphate and other anticonvulsants for women with pre-eclampsia","volume":"2010","author":"L Duley","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1097\/AOG.0b013e3181a60495","article-title":"Antenatal magnesium sulfate and neurologic outcome in preterm infants: a systematic review","volume":"113","author":"L W Doyle","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1080\/14767058.2017.1317743","article-title":"Antenatal magnesium sulfate for both tocolysis and fetal neuroprotection in premature rupture of the membranes before 32 weeks' gestation","volume":"31","author":"E J Jung","year":"2018","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"03","key":"ref14","first-page":"CD004454","article-title":"Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth","volume":"3","author":"D Roberts","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"issue":"12","key":"ref15","doi-asserted-by":"crossref","first-page":"e1002988","DOI":"10.1371\/journal.pmed.1002988","article-title":"Antenatal magnesium sulphate and adverse neonatal outcomes: a systematic review and meta-analysis","volume":"16","author":"E Shepherd","year":"2019","journal-title":"PLoS Med"}],"container-title":["American Journal of 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