Thursday, April 19, 2007

Magnesium Sulfate Protects Preemies?

I received mag with both Grace and Meghan while I was still pregnant. Hmmmm...

Magnesium sulfate may protect very preterm infants from brain injury

Reuters Health - Apr. 17, 2007

NEW YORK (Reuters Health) - Magnesium sulfate given before very preterm birth may protect infants against brain injury without harming the mother, according to a report in the March issue of BJOG: An International Journal of Obstetrics and Gynecology. However, the benefit is not strong enough to recommend widespread adoption of the strategy.

Several reports have suggested that prenatal administration of magnesium sulfate for tocolysis or preeclampsia is associated with lower neonatal mortality and lower risk of cerebral palsy in very-low-birth-weight children, the authors explain.

Dr. Stephane Marret from Rouen University Hospital, France and associates investigated whether a single infusion of magnesium sulfate to women at risk of very preterm delivery would prevent neonatal mortality and/or white matter injury.

Slightly more women treated with magnesium sulfate (53.9%) had prolonged prelabor rupture of membranes (PPROM) than women who received placebo (46.6%), the authors report, but otherwise the groups had similar maternal and pregnancy characteristics.

There were no major maternal adverse effects among women treated with magnesium sulfate, the results indicate, and labor and delivery outcomes were similar for the two groups. Women in the magnesium sulfate group did, however, have a significantly higher rate of maternal-fetal infections.

Total neonatal mortality before hospital discharge, severe white matter injury, and the combination of the two were lower for the magnesium sulfate group, the researchers note, but the differences did not reach statistical significance.

Secondary cranial ultrasound outcomes also did not differ significantly among the 665 infants with available data, the report indicates, although the rate of all white matter injury and the rate of nonparenchymal hemorrhages were lower in the magnesium sulfate group than in the placebo group.

"The lack of a significant magnesium sulfate effect ... may be explained by the higher frequencies of PPROM and/or maternal-fetal infection observed in our magnesium sulfate group that may have counterbalanced the neuroprotective effect of magnesium," the investigators say.

"Our findings suggest a neuroprotective effect of magnesium sulfate given before very-preterm birth but do not provide strong enough evidence for recommending widespread magnesium sulfate use in clinical practice," Dr. Marret and colleagues conclude.

BJOG 2007;114:310-318.

1 comment:

Lauren said...

You know, this makes sense. I have always wondered how your girls got lucky in that sense! They actually are somewhat of a statistical anomaly in terms of not having any brain insults/injuries... thank goodness!!!!!