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Magnesium sulfate to mothers just prior to delivery of preterm babies may improve outcomes

Women who are given intravenous magnesium sulfate just before the birth of a very preterm baby may reduce the infant's risk of neurosensory impairments such as cerebral palsy, though this finding needs to be confirmed in other studies before it becomes standard practice, according to an article in the November 26 issue of The Journal of the American Medical Association (JAMA).

Infants born very preterm have increased risks of death or neurosensory impairments and disabilities such as cerebral palsy, according to background information in the article. Although other studies have suggested that use of prenatal magnesium sulfate may act as a neuroprotective agent for very preterm infants, there have been no large randomized controlled trials in which magnesium sulfate was given solely for neuroprotection.

Caroline A. Crowther, M.D., of The University of Adelaide, South Australia, and colleagues conducted a study to determine the effectiveness of magnesium sulfate in preventing pediatric death and/or cerebral palsy when given to women at risk of delivery before 30 weeks' gestation.

The study was a randomized controlled trial at 16 hospitals in Australia and New Zealand. It included 1,062 women with fetuses younger than 30 weeks' gestation for whom delivery was planned or expected within 24 hours. The participants were enrolled from February 1996 to September 2000 with follow-up of surviving children at 2 years of age. Women were randomly assigned to receive an intravenous infusion of magnesium sulfate solution or sodium chloride solution (as placebo) for 20 minutes followed by a maintenance infusion for up to 24 hours.

Data were analyzed for 1,047 (99 percent) 2-year survivors. "Total pediatric mortality (13.8 percent vs. 17.1 percent; [17 percent reduced risk]), cerebral palsy in survivors (6.8 percent vs. 8.2 percent; [17 percent reduced risk]), and combined death or cerebral palsy (19.8 percent vs. 24.0 percent; [17 percent reduc
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25-Nov-2003


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