Cerebral Palsy Risk in Premature Infants May Safely Be Reduced by Magnesium Sulfate Supplements, Study Says

Researchers in China investigating the efficacy and safety of magnesium sulfate supplementation as a neuroprotective agent for preterm infants treated in utero, reported that its use is safe and beneficial for babies at risk of a premature birth, despite findings of potentially harmful side effects in their mothers.

The article, by researchers at the Department of Obstetrics and Gynecology at Xi’an Jiao Tong University, is titled “Effects and Safety of Magnesium Sulfate on Neuroprotection: A Meta-analysis Based on PRISMA Guidelines” and published in the journal Medicine (Baltimore).

Babies born between 24 and 37 gestational weeks are at an increased risk of early death, and those who survive have a higher predisposition for neurological impairments, such as cerebral palsy (CP), blindness, motor dysfunction, and deafness.

CP has been reported as the leading cause of neurological impairment in preterm children. Advancements in medicine and healthcare have improved survival rates among these infants, and led to rising numbers of children with subsequent neurological impairment. Potential therapies for babies at risk of being born prematurely include magnesium sulfate supplements, shown to be associated with a decreased risk of CF development in preterm infants. However, other studies dispute findings of a beneficial effect, and some have reported serious side effects in pregnant women, such as palpitations, hypotension, and renal failure.

As the safety and neuroprotective effectiveness of magnesium sulfate remains controversial, researchers sought to evaluate the existing evidence regarding this supplement’s use, both on infant neuroprotection and the mother’s health. The researchers analyzed 10 studies, found in electronic databases and research bibliographies, which included a total of 18,655 preterm infants.

According to the analysis, which used PRISMA guidelines (evidence-based guidelines for reporting data in systematic reviews and meta-analyses), researchers observed that magnesium sulfate significantly reduced the risk of moderate to severe CP, although no significant clinical difference was found regarding mortality rates. No adverse effects were observed in the babies following its administration. In mothers, however, significant side effects were observed, including respiratory depression and nausea, although they presented with considerable heterogeneity.

The research team concluded that the possibility of harmful side effects in mothers might be lessened by reducing the magnesium sulfate dose, and that magnesium sulfate supplementation is both beneficial and safe as a neuroprotective agent for premature infants until a more “valid alternative” is found.