Survey on use of antenatal magnesium sulphate for fetal neuroprotection prior to preterm birth in Australia and New Zealand - Ongoing barriers and enablers

Aust N Z J Obstet Gynaecol. 2020 Feb;60(1):44-48. doi: 10.1111/ajo.12981. Epub 2019 May 22.

Abstract

Background: Clinical practice guidelines recommend the use of antenatal magnesium sulphate for fetal neuroprotection before preterm birth at <30 weeks' gestation.

Aims: This survey assessed the use of antenatal magnesium sulphate for fetal neuroprotection to determine if use has changed since the previous survey in 2012, and to evaluate enablers and barriers to use.

Materials and methods: A questionnaire was sent to clinical leaders at 29 hospitals with a neonatal intensive care unit in Australia and New Zealand asking at what gestational ages magnesium sulphate was given, if use was audited and any enablers and barriers to use.

Results: Responses were received for 24 (83%) hospitals. The use of magnesium sulphate for fetal neuroprotection was reported as 89% (IQR 80-90%), an increase from 80% (IQR 53-90%) from the earlier survey. The majority of health professionals were reported as using magnesium sulphate at <30 weeks' gestation. The top enablers for use of magnesium sulphate were availability of pamphlets, posters, case record stickers and PowerPoint presentations. The main reasons as to why eligible women did not receive magnesium sulphate were imminent birth, the hospital being short staffed and the patient declined. The use of antenatal magnesium sulphate has been or is being audited in 11 (46%) of the hospitals.

Conclusions: Clinical leaders at institutions in Australia and New Zealand report that uptake in the use of magnesium sulphate for fetal neuroprotection has continued to increase since the earlier, bi-national survey in 2012. Barriers to the use of magnesium sulphate identified have institutional and consumer implications.

Keywords: clinical practice guideline; fetal neuroprotection; magnesium sulphate; preterm birth; survey.

MeSH terms

  • Australia
  • Cerebral Palsy / prevention & control*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Magnesium Sulfate / administration & dosage*
  • Neuroprotective Agents
  • New Zealand
  • Pregnancy
  • Premature Birth / drug therapy*
  • Surveys and Questionnaires
  • Tocolytic Agents / administration & dosage*

Substances

  • Neuroprotective Agents
  • Tocolytic Agents
  • Magnesium Sulfate