Can MgSO4 prevent cerebral palsy?

In women with anticipated early preterm delivery, intravenous maternal magnesium sulfate cuts the risk of moderate-to-severe cerebral palsy in half, according to research presented in February at the 28th Annual Meeting of the Society for Maternal-Fetal Medicine in Dallas.

Dwight J. Rouse, MD, of the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network in Bethesda, Md., and colleagues randomly assigned 2,241 women who had preterm premature rupture of membranes, advanced preterm labor, or indicated delivery from 24 to 31 weeks' gestation and no signs of preeclampsia, to receive either placebo or IV treatment with 6 g of magnesium sulfate followed by administration of 2 g of magnesium sulfate per hour.

Compared to the placebo group, the researchers found that magnesium sulfate had no effect on reducing rates of the primary study outcome: a composite of moderate or severe cerebral palsy at the corrected age of 2 years or death (RR, 0.97). But they found that magnesium sulfate dramatically lowered the threat of moderate-to-severe cerebral palsy alone (RR, 0.55).

"[Magnesium sulfate] did not reduce the rate of the primary outcome of moderate-to-severe cerebral palsy or death, perhaps because death was the predominant component of the outcome," the authors write.