Does Antenatal Magnesium Sulphate improve hearing function in premature newborns

Objective: To evaluate whether antenatal magnesium sulphate (MgSO4) exposure has a neuroprotective effect against hearing impairment in premature newborns. Materials and Methods: Retrospective cohort study performed with prematurely (<37 weeks) delivered newborns at a tertiary university hospital. Newborns of 92 women who received MgSO4 infusions (study group) for various indications were compared to newborns of 147 women who did not receive MgSO4 infusions (control group). Every eligible premature newborn underwent hearing screening by auditory brainstem response (ABR) testing before being discharged from the hospital. Results: The fail rate in ABR hearing screening was 3.3% (n=3) in the study group and 10.9% (n=16) in the control group (p=0.034). The rate of concurrent use of betamethasone was higher in the study group (72.8%; n= 67) compared to control group (29.2%; n=43) (p<0.001). Other neonatal parameters such as the number of neonates who are small for gestational age and the rate of microcephaly were similar between the groups (p=0.54, p=0.48, respectively). After adjusting for co-variates including the use of betamethasone and gestational age at delivery, we did not find any statistically significant association between antenatal administration of MgSO4 and fail rates in hearing screening by ABR testing (p=0.07). Conclusion: Our results do not suggest a clear and definite benefit from antenatal MgSO4 infusion in respect of hearing impairment in premature newborns.