This multicenter study, co-funded by the National Institute of Neurological Disorders and Stroke and conducted by the 20 participating research centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network, enrolled 2,241 women between Dec.1997 and March 2004. The women were randomly assigned to receive either placebo or magnesium sulfate. They all had similar characteristics, including gestational age (24 to 31 weeks) at randomization and risk factors for preterm birth. Eighty-seven percent of the women had experienced preterm membrane rupture.
Those in the treatment group were given six grams of magnesium sulfate intravenously over 20 to 30 minutes, followed by two grams of magnesium sulfate every hour after that until either 12 hours had passed, labor subsided or they had given birth. If the women in either group did not deliver within 12 hours, they were treated again if they went into labor by the 34th week of pregnancy.
On follow up at two years of age, researchers found that babies born to women in the treatment group had a significantly lower rate of all forms of cerebral palsy, 4.2 percent vs. 7.3 percent, and of moderate or severe cerebral palsy, 1.9 percent vs. 3.5 percent. Children with moderate cerebral palsy cannot walk unaided, and those with severe cerebral palsy are profoundly disabled.
"Our finding that magnesium sulfate protects against cerebral palsy is consistent with two previous randomized trials, both of which were well done and which in total enrolled over 1,600 women. Our trial and the two others show that magnesium sulfate can reduce the risk of this devastating condition in preterm infants. Until we can prevent early preterm birth, the best that we obstetricians can do is to improve the prospects for infants who are born very early. I think that our study says that magnesium sulfate can help
|Contact: Jennifer Lollar|
University of Alabama at Birmingham