Magnesium sulfate given to pregnant women at risk of preterm birth can prevent cerebral palsy and reduce the combined risk of fetal/infant death or cerebral palsy, researchers found.
The study, “Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant data meta-analysis,” was published in the journal PLoS Medicine. It’s a result of the joint work of universities and research institutes from the United States, Australia, New Zealand, United Kingdom, and France.
Premature (preterm) birth, occurring before 37 weeks gestation, is a risk factor that can lead to death in the first weeks of life. Compared to full-term (39-40 weeks gestation) babies, preterm infants have a higher rate of cerebral palsy.
The medical community supports short-term use of magnesium sulfate for fetal neuroprotection before early preterm delivery (less than 32 weeks gestation), and short-term prolongation of pregnancy (up to 48 hours).
Researchers aimed to evaluate the effects of antenatal (before birth) magnesium sulfate given to pregnant women at risk of preterm birth with important maternal and fetal outcomes. The team also assessed whether effects of treatment varied according to the treatment characteristics or study participants.
To do so, researchers performed a meta-analysis of individual participant data. This is a statistical analysis of each participant’s data from several separate but similar studies. Combining pertinent data from various studies usually gives a conclusion with greater statistical power.
Scientists analyzed data from five randomized trials with 5,493 women at risk of preterm birth who received antenatal magnesium sulfate or a control treatment. From these same studies, neurological measures from 6,131 babies were also analyzed.
In four of the selected trials, in which the treatment’s purpose was fetal neuroprotection, the statistical analysis showed that magnesium sulfate indeed reduced the combined risk of fetal/infant death or cerebral palsy, compared to the non-treated group.
Regarding cerebral palsy in babies who survived preterm birth, treatment with magnesium sulfate demonstrated a strong protective effect.
No matter the reason for the premature birth, magnesium sulfate showed a clinical benefit at different preterm gestational ages.
“Antenatal magnesium sulphate given prior to preterm birth for fetal neuroprotection prevents CP [cerebral palsy] and reduces the combined risk of fetal/infant death or CP,” the researchers concluded. “Benefit is seen regardless of the reason for preterm birth, with similar effects across a range of preterm gestational ages and different treatment regimens.”
The team believes that “widespread adoption worldwide of this relatively inexpensive, easy-to-administer treatment would lead to important global health benefits for infants born preterm.”
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