{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:13:16Z","timestamp":1788495196637,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n \n Magnesium sulfate (MgSO\n 4<\/jats:sub>\n ) administered before very preterm birth reduces the risk of cerebral palsy in surviving infants and is recommended in international guidelines. In April 2020, a national guideline for MgSO\n 4<\/jats:sub>\n for fetal neuroprotection was introduced in Denmark. We evaluated clinical uptake and adherence following guideline implementation.\n <\/jats:p>\n <\/jats:sec>\n \n Material and Methods<\/jats:title>\n \n This retrospective medical chart review study included women who delivered at gestational age 24\u2009+\u20090 to 31\u2009+\u20096\u2009weeks of gestation at nine different Danish hospitals between April 2020 and December 2023. These departments handled around 50% of all deliveries in Denmark in this period. Data were obtained from electronic medical records. The primary outcome was administration of MgSO\n 4<\/jats:sub>\n for fetal neuroprotection among eligible women. Secondary outcomes included temporal trends in uptake, differences by gestational age and hospital size, and documented reasons for non\u2010administration. Descriptive statistics were used to summarize uptake rates and patient characteristics, and comparisons were performed using appropriate statistical tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 583 eligible women were included. Overall, 481 women (83%) received MgSO\n 4<\/jats:sub>\n for fetal neuroprotection; of these, 340 women (71%) received MgSO\n 4<\/jats:sub>\n within 24\u2009h of birth. Uptake was highest among women delivering before 28\u2009weeks of gestation, where MgSO\n 4<\/jats:sub>\n was administered in nearly all eligible cases. Among women delivering between 28\u2009+\u20090 and 31\u2009+\u20096\u2009weeks, approximately one in five did not receive treatment. Uptake did not increase over the study period, suggesting early adoption followed by stable implementation. Large\u2010volume hospitals demonstrated higher treatment rates compared with smaller hospitals. The most frequent reasons for non\u2010administration were lack of guideline awareness\/oversight at later gestational ages and rapid delivery or maternal\/fetal instability at earlier gestations.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Following the implementation of the national guideline, uptake of MgSO\n 4<\/jats:sub>\n for fetal neuroprotection in Denmark was high but incomplete. Persistent gaps in treatment, particularly among women delivering after 28\u2009weeks of gestation, indicate a need for targeted implementation strategies to improve adherence and ensure equitable neuroprotective care.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aogs.70348","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:24:31Z","timestamp":1788492271000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnesium sulfate for neuroprotection before preterm birth: Uptake and adherence in clinical practice after National Guideline Implementation"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4598-9938","authenticated-orcid":false,"given":"Hanne Trap","family":"Wolf","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Zealand University Hospital Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofie Elise","family":"Gellert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Hvidovre Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene Drasbek","family":"Huusom","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Herlev University Hospital Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4455-713X","authenticated-orcid":false,"given":"Mads Langager","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Hvidovre University Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"issue":"10","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1111\/1471-0528.16238","article-title":"Magnesium sulphate for fetal neuroprotection at imminent risk for preterm delivery: a systematic review with meta\u2010analysis and trial sequential analysis","volume":"127","author":"Wolf HT","year":"2020","journal-title":"BJOG"},{"issue":"5","key":"e_1_2_13_3_1","article-title":"Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus","volume":"5","author":"Shepherd ES","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_4_1","unstructured":"WHO.WHO recommendations on interventions to improve preterm birth outcomes.2023.https:\/\/www.icn.ch\/sites\/default\/files\/2023\u201004\/te"},{"key":"e_1_2_13_5_1","unstructured":"ACOG.Magnesium sulfate before anticipated preterm birth for neuroprotection.https:\/\/www.acog.org\/clinical\/clinical\u2010guidance\/committee\u2010opinion\/articles\/2010\/03\/magnesium\u2010sulfate\u2010before\u2010anticipated\u2010preterm\u2010birth\u2010for\u2010neuroprotection2023."},{"key":"e_1_2_13_6_1","unstructured":"NICE Guideline.Preterm labour and birth.https:\/\/www.nice.org.uk\/guidance\/ng25\/chapter\/Recommendations#magnesium\u2010sulfate\u2010for\u2010neuroprotection2022."},{"key":"e_1_2_13_7_1","unstructured":"Wolfet\u00a0al.Magnesium sulfate as neuroprotection in preterm birth.2020.https:\/\/static1.squarespace.com\/static\/5467abcce4b056d72594db79\/t\/5ead56c5f238824757ec2907\/1588418248981\/200423+Magnesium+sulfat+final+guideline.pdf"},{"issue":"47","key":"e_1_2_13_8_1","article-title":"Magnesium sulphate treatment decreases the risk of cerebral palsy after preterm birth","volume":"182","author":"Wolf HT","year":"2020","journal-title":"Ugeskr Laeger"},{"issue":"10","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1111\/1471-0528.16239","article-title":"Antenatal magnesium sulphate for the prevention of cerebral palsy in infants born preterm: a double\u2010blind, randomised, placebo\u2010controlled, multi\u2010centre trial","volume":"127","author":"Wolf HT","year":"2020","journal-title":"BJOG"},{"issue":"12","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1111\/aogs.14673","article-title":"A follow up on the feasibility after national implementation of magnesium sulfate for neuroprotection prior to preterm birth","volume":"102","author":"Hellstr\u00f6m S","year":"2023","journal-title":"Acta Obstet Gynecol Scand"},{"key":"e_1_2_13_11_1","unstructured":"Sundhedsdatabank.F\u00f8dsler pr. region 1997\u20132024.2025(Udgivet%25201.%2520maj%25202025). 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A systematic review of reported effects and methodological rigor in plan\u2010do\u2010study\u2010act projects","volume":"19","author":"Knudsen SV","year":"2019","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"e_1_2_13_18_1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1136\/archdischild-2021-321817","article-title":"Antenatal magnesium sulfate to prevent cerebral palsy","volume":"107","author":"Keir AK","year":"2022","journal-title":"Arch Dis Child Fetal Neonatal Ed"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70348","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70348","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70348","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:24:36Z","timestamp":1788492276000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":17,"alternative-id":["10.1111\/aogs.70348"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70348","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"assertion":[{"value":"2025-12-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"aogs.70348"}}