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Effect of magnesium sulphate on persistent pulmonary hypertension of the newborn: a systematic review and meta-analysis

Published online by Cambridge University Press:  24 July 2025

Zhe Tang ,
Ziwei Wang  and
Xinbao Wang Open the ORCID record for Xinbao Wang [Opens in a new window]
Zhe Tang
Affiliation:
Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Ziwei Wang
Affiliation:
Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Xinbao Wang*
Affiliation:
Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
*
Corresponding author: Xinbao Wang; Email: xinbaowang2008@163.com
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Abstract

Objective:

Persistent pulmonary hypertension of the newborn is a serious disease with significant morbidity and mortality. Magnesium sulphate has been proposed as a potential treatment for persistent pulmonary hypertension of the newborn, but its efficacy remains unclear. The article aims to evaluate the effects of magnesium sulphate on persistent pulmonary hypertension of the newborn.

Methods:

A comprehensive search of PubMed, Web of Science, Embase, and Cochrane Library was conducted to identify relevant studies. The primary outcomes were pulmonary artery pressure and oxygenation index, while secondary outcomes included mean blood pressure, alveolar-arterial oxygen difference, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and arterial oxygen saturation. Statistical analysis was performed by Cochrane Review Manager 5.3.

Results:

The study analysed twelve studies involving 380 patients. Results indicated that magnesium sulphate treatment significantly reduced pulmonary artery pressure levels (MD −24.96, 95% CI −28.19 to −21.73, P < 0.0001) and mean blood pressure (MD −3.11, 95% CI −3.91 to −2.32, P < 0.0001) compared to pretreatment. Additionally, it led to a notable decrease in oxygenation index (P < 0.00001) and alveolar-arterial oxygen difference (P < 0.0001), while increasing PaO2 (P < 0.0001) and arterial oxygen saturation (P < 0.001). However, there was no significant effect on PaCO2 levels compared to pretreatment.

Conclusion:

Magnesium sulphate is a valuable therapy for persistent pulmonary hypertension of the newborn. It markedly reduced pulmonary artery pressure, alveolar-arterial oxygen difference, and oxygenation index, while enhancing PaO2, and arterial oxygen saturation, with no impact on PaCO2 levels. Magnesium sulphate may also reduce mean blood pressure following a 2-hour treatment. Additional studies are necessary to further clarify its efficacy and potential side effects.

Registration:

This study was registered with PROSPERO (CRD42024578092).

Keywords

Magnesium sulphateneonatepersistent pulmonary hypertension of the newbornmeta-analysis

Information

Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 6 , June 2025 , pp. 1225 - 1232
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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