Term Neonatal Outcomes after Maternal Magnesium Sulfate Treatment for Seizure Prophylaxis.

OBJECTIVE: This study aimed to evaluate term neonatal outcomes after maternal magnesium sulfate (MgSO4) treatment for seizure prophylaxis. STUDY DESIGN: This was a single-site retrospective cohort study of all women with term singleton gestation requiring MgSO4 treatment for seizure prophylaxis and their respective neonatal outcomes from January 2013 through December 2020. Our primary outcome was neonatal intensive care unit (NICU) admission. We compared outcomes between women treated with MgSO4 for 24 hours or more and women treated with MgSO4 for less than 24 hours prior to delivery. Multivariable logistic regression was performed to calculate adjusted odds ratio (aOR) and 95% confidence interval (95% CI), controlling for variables with a p < 0.05 based on bivariable analysis. RESULTS: Of 834 women analyzed, 173 (20.7%) neonates were admitted to the NICU. Women treated with MgSO4 for 24 hours or more compared with women treated with MgSO4 for less than 24 hours were more likely to have neonates admitted to the NICU during their hospitalization (27.3 vs. 18.9%; p = 0.01), neonates requiring immediate NICU admission (24.6 vs. 18.3%; p < 0.01), and NICU admission for neonatal lethargy. After adjusting for covariates, only NICU admission due to neonatal lethargy remained statistically significant (aOR: 4.78 [95% CI: 1.50-15.21]). CONCLUSION: Prolonged MgSO4 treatment for 24 hours or more was associated with increased odds of term NICU admission due to neonatal lethargy. KEY POINTS: · NICU admission rose with longer magnesium treatment.. · Nulliparous patients had more magnesium sulfate exposure.. · Obese patients had longer magnesium sulfate exposure..

Predictors of colorectal carcinoma and inflammatory bowel disease in patients with colonic wall thickening.

Background and Aim: Colonic wall thickening (CWT) is commonly associated with clinically significant pathologies, but predictive factors of such pathologies are not well known. This study aims to identify the predictors of clinically significant pathologies, such as colorectal carcinoma (CRC) and inflammatory bowel disease (IBD), in patients with CWT. Methods: Subjects with an abnormal abdominal computed tomography (CT) and a follow-up colonoscopy between 2010 and 2020 were retrospectively reviewed. Patients with CWT in the CT were included and examined in this study. A multivariable logistic regression analysis was performed to assess for factors independently associated with CRC or IBD in these subjects. Receiver operating characteristic (ROC) curve analysis was used to further examine significant parameters in multivariable logistic regression analysis. Results: Among 403 patients with CWT on CT scans who underwent a colonoscopy, 269 subjects who met the inclusion criteria were identified and studied. On multivariable logistic regression models, elevated platelet count, low hematocrit, and localized CWT were found to be independently associated with CRC, while elevated platelet count and younger age were independently associated with IBD. On ROC curve analysis for CRC, area under the curve (AUC) for hematocrit, platelets, and localized CWT was 0.76, 0.75, and 0.61, respectively. On ROC curve analysis for IBD, AUC for age and platelets was 0.90 and 0.69, respectively. Conclusion: Elevated platelet count, low hematocrit, and localized CWT can be potentially used as predictors of CRC in patients with CWT. Elevated platelet count and young age can be used to predict IBD in these patients.