Magnesium Sulphate to Reduce CP Risk in Preterm Babies Is Safe If Used Properly, Study Finds

Magnesium sulfate, given to pregnant mothers in preterm labor to reduce the risk of cerebral palsy (CP) in the infant, does not give rise to other safety issues, a collaborative study between Canadian and U.K. scientists found.

Earlier evidence from an analysis of multiple studies suggests that magnesium sulfate, taken before the 32nd week of pregnancy, reduces the risk of babies developing cerebral palsy when they are delivered prematurely.

Researchers think the mineral is neuroprotective. The supplement is recommended by the Society of Obstetricians and Gynaecologists of Canada, but some researchers have been concerned that the mineral may have a negative effect on fetal heart rates, and increase the need for resuscitation of newborns.

However, a study of thousands of women in Canada showed that newborn resuscitation rates actually decreased with increased use of the supplement.

The study, “MAGnesium sulphate for fetal neuroprotection to prevent Cerebral Palsy (MAG-CP)—implementation of a national guideline in Canada,” was published in the journal Implementation Science.

Researchers at the University of British Columbia in Canada and King’s College London in the U.K. examined the safety profile of magnesium sulfate in conjunction with a program teaching clinicians about the supplement, aiming to close a knowledge gap around its use. The educational program included online modules, on-site sessions, and small focus groups.

The research team identified 4,745 women at 18 clinics who were treated before the educational programs were introduced, and 3,143 women treated at 11 centers during the intervention. The program included instruction about the optimal window for use of magnesium sulfate.

Providing education to clinicians improved the correct use of the supplement, suggesting that focused efforts are valuable in implementing knowledge from studies into clinical practice, researchers reported. Data showed the odds of optimal use of magnesium sulfate increased by 84% during the intervention period, while the amount of underuse went down. But suboptimal use — when the mineral was given too early or later than at week 32 of pregnancy — also increased.

Despite the significant increase in the use of magnesium sulfate after the intervention, the team found a decrease in newborn resuscitation rates: Of infants born to mothers who received the supplement, about 30% required resuscitation, compared with around 40% of infants born to mothers who did not receive the supplement.

The results confirm the findings from other recent studies showing no increase in resuscitation rates with magnesium sulfate, and in some cases, a decrease, researchers wrote.