日本新生児成育医学会雑誌　38(2)：282-288；2026　

日本新生児成育医学会雑誌　第38巻　第2号　90 ～ 96頁（2026年）

受付日：2025．10．30

受理日：2026．02．24

母体硫酸マグネシウム投与と早産児の症候性動脈管開存症の関連

Association Between Antenatal Magnesium Sulfate Administration and Symptomatic Patent Ductus Arteriosus in Preterm Infants

富山大学附属病院周産母子センター　新生児部門

Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital

笹本亨太・猪又智実・長岡貢秀・川﨑裕香子・田村賢太郎・吉田丈俊

Kyota SASAMOTO，Satomi INOMATA，Mitsuhide NAGAOKA，Yukako KAWASAKI，Kentaro TAMURA，Taketoshi YOSHIDA

Key Words：patent ductus arteriosus，magnesium sulfate，preterm infant

目的：母体硫酸マグネシウム（MgSO4）投与が，早産児の動脈管開存症（patent ductus arteriosus：PDA）の症候 化に及ぼす影響を明らかにする。 方法：当院に入院した在胎26 ～ 33 週の単胎早産児242 例を対象とし，母体MgSO4 投与と症候性PDA 発症の関連 を後方視的に検討し，出生時血清Mg 濃度を共変量とした多変量解析および在胎週数別層別解析を加えた。 結果：在胎週数，small for gestational age，性別で調整した多変量解析で，母体MgSO4 投与群で症候性PDA 発症 率が有意に高く（p＝0.032），出生時血清Mg 濃度が高いほど症候化が増加した（p＝0.047）。在胎週数別解析では， 在胎26 ～ 27 週群でのみ母体MgSO4 投与により症候性PDA 発症率が有意に増加した（p＝0.021）。 結論：母体MgSO4 投与と出生時血清Mg 濃度は症候性PDA 発症に関与し，特に在胎26 ～ 27 週の児で注意が求め られる。

Objective：We aimed to clarify the effect of antenatal magnesium sulfate （MgSO4） administration on the incidence of symptomatic patent ductus arteriosus（ PDA） in preterm infants. Methods：We retrospectively analyzed 242 singleton preterm infants born at 26 ～ 33 weeks of gestation who were admitted to our neonatal intensive care unit. The association between antenatal MgSO4 administration and the incidence of symptomatic PDA was examined, with multivariate analysis including neonatal serum magnesium（ Mg） concentration at birth as a covariate, and analyses stratified by gestational age. Results：Multivariate analysis adjusted for gestational age, small for gestational age status, and sex showed that the incidence of symptomatic PDA was significantly higher in the MgSO4-exposed group（ p＝0.032）. In addition, higher neonatal serum Mg concentrations at birth were associated with an increased incidence of symptomatic PDA （p＝0.047）. In gestational age–stratified analyses, antenatal MgSO4 exposure was significantly associated with symptomatic PDA only among infants born at 26～ 27 weeks（ p＝0.021）, whereas no significant association was observed in infants born at ≥28 weeks. Conclusions：Antenatal MgSO4 administration and elevated neonatal serum Mg concentration were associated with symptomatic PDA, notably in infants born at 26 ～ 27 weeks of gestation.