{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:05:08Z","timestamp":1787317508461,"version":"build-2736575974"},"reference-count":30,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,5,1]]},"abstract":"<jats:p>OBJECTIVE. The goal was to study whether postnatal magnesium sulfate infusion could improve neurologic outcomes at discharge for term neonates with severe perinatal asphyxia.<\/jats:p>\n                  <jats:p>METHODS. Forty term (\u226537 weeks of gestation) neonates with severe perinatal asphyxia were studied in a prospective, longitudinal, placebo-controlled trial. Patients were assigned randomly to receive either 3 doses of magnesium sulfate infusion at 250 mg\/kg per dose (1 mL\/kg per dose) 24 hours apart (treatment group) or 3 doses of normal saline infusion (1 mL\/kg per dose) 24 hours apart (placebo group). Both groups also received supportive care according to the unit protocol for perinatal asphyxia.<\/jats:p>\n                  <jats:p>RESULTS. In the treatment group, moderate encephalopathy was present in 35% (7 of 20) of the patients and severe encephalopathy in 65% (13 of 20) of patients at admission. In the placebo group, 40% (8 of 20) of patients had moderate encephalopathy and 60% (12 of 20) of patients had severe encephalopathy. The mean serum magnesium concentration in the treatment group remained at \u22651.2 mmol\/L for 72 hours after the first infusion. At discharge, 22% (4 of 18) of infants in the treatment group had neurologic abnormalities, compared with 56% (10 of 18) of infants in the placebo group. Also, neuroimaging (head computed tomography) performed on day 14 yielded abnormal findings for fewer infants in the treatment group than in the placebo group (16% vs 44%). Infants in the treatment group were more likely to be receiving oral feedings (sucking) at discharge than were those in the placebo group (77% vs 37%). Good short-term outcomes at discharge occurred for 77% of the patients in the treatment group, compared with 37% of the patients in the placebo group.<\/jats:p>\n                  <jats:p>CONCLUSION. Postnatal magnesium sulfate treatment improves neurologic outcomes at discharge for term neonates with severe perinatal asphyxia.<\/jats:p>","DOI":"10.1542\/peds.2007-3642","type":"journal-article","created":{"date-parts":[[2009,4,6]],"date-time":"2009-04-06T20:34:27Z","timestamp":1239050067000},"page":"e764-e769","source":"Crossref","is-referenced-by-count":74,"title":["Magnesium Sulfate in Severe Perinatal Asphyxia: A Randomized, Placebo-Controlled Trial"],"prefix":"10.1542","volume":"123","author":[{"given":"Mushtaq Ahmad","family":"Bhat","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashir Ahmad","family":"Charoo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javeed Iqbal","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheikh Mushtaq","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Wajid","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masood-ul-Hassan","family":"Mufti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2009,5,1]]},"reference":[{"key":"2021120902413495700_R1","unstructured":"Adcock LM, Papile LA. 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Pediatrics.\u20082002;109(1):26\u201333","DOI":"10.1542\/peds.109.1.26"},{"key":"2021120902413495700_R6","doi-asserted-by":"crossref","unstructured":"Robertson CM, Finer NN, Grace MG. School performance of survivors of neonatal encephalopathy associated with birth asphyxia at term. J Pediatr.\u20081989;114(5):753\u2013760","DOI":"10.1016\/S0022-3476(89)80132-5"},{"key":"2021120902413495700_R7","unstructured":"Volpe JJ. Neurology of the Newborn. Philadelphia, PA: Saunders; 2001:331\u2013382"},{"key":"2021120902413495700_R8","doi-asserted-by":"crossref","unstructured":"Benveniste H, Drejer J, Schousboe A, Diemer NH. Elevation of the extracellular concentrations of glutamate and aspartate in rat hippocampus during transient cerebral ischemia monitored by intracerebral microdialysis. J Neurochem.\u20081984;43(5):1369\u20131374","DOI":"10.1111\/j.1471-4159.1984.tb05396.x"},{"key":"2021120902413495700_R9","unstructured":"Choi DW, Hartley DM. Calcium and glutamate induced cortical neuronal death. In: Waxman SG, eds. Molecular and Cellular Approaches to the Treatment of Neurological Disease. New York, NY: Raven Press, 1993:23\u201324"},{"key":"2021120902413495700_R10","doi-asserted-by":"crossref","unstructured":"Lorek A, Takei Y, Cady EB, et al. Delayed (\u201csecondary\u201d) cerebral energy failure after acute hypoxia-ischemia in the newborn piglet: continuous 48-hour studies by phosphorus magnetic resonance spectroscopy. Pediatr Res.\u20081994;36(6):699\u2013706","DOI":"10.1203\/00006450-199412000-00003"},{"key":"2021120902413495700_R11","doi-asserted-by":"crossref","unstructured":"Nowak L, Bregestovski P, Ascher P, Herbet A, Prochiantz A. Magnesium gates glutamate-activated channels in mouse central neurones. Nature.\u20081984;307(5950):462\u2013465","DOI":"10.1038\/307462a0"},{"key":"2021120902413495700_R12","doi-asserted-by":"crossref","unstructured":"Henneberry RC, Novelli A, Cox JA, Lysko PG. 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