In the 3 large, well-done randomized placebo-controlled trials, antenatal magnesium
sulfate (MgSO4) reduced the risk of cerebral palsy among children who survived early preterm birth.
Crowther and colleagues
1
studied 1062 women. Moderate or severe cerebral palsy (inability to walk unaided)
was significantly less frequent among children in the MgSO4 group, 3.4% vs 6.6%. In the National Institutes of Health Maternal-Fetal Medicine
Units Network trial (the BEAM trial) 2241 women were enrolled.
2
As in the trial of Crowther et al,
1
MgSO4 significantly reduced the risk of moderate to severe cerebral palsy, 1.9% vs 3.5%.
Among the offspring of women randomized <28 weeks, the respective risks were 2.7%
and 6.1%. Marret et al
3
studied 573 mothers: MgSO4 lowered the risk of cerebral palsy, 7.0% vs 10.2%. These 3 trials and 2 more (6145
children) are included in a Cochrane Systematic Review that concluded that MgSO4 reduced the risk of cerebral palsy by 32% but had no effect on fetal or infant mortality.
4
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References
- Effect of magnesium sulfate given for neuroprotection before preterm birth: a randomized controlled trial.JAMA. 2003; 290: 2669-2676
- A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy.N Engl J Med. 2008; 359: 895-905
- Effect of magnesium sulphate on mortality and neurologic morbidity of the very preterm newborn with two-year neurological outcome: results of the prospective PREAMAG trial.Gynecol Obstet Fertil. 2008; 36: 278-288
- Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus.Cochrane Database Syst Rev. 2009; 1 (CD004661)
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© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.