Magnesium sulfate for the prevention of cerebral palsy

Abstract

Three large, randomized placebo-controlled trials of antenatal MgSO4 for fetal neuroprotection have been conducted; separately and together, they demonstrate that MgSO4 diminishes the risk of cerebral palsy among the survivors of early preterm birth. A meta-analysis of these three trials, and a fourth, smaller one, shows that not only does the maternal administration of magnesium sulfate for fetal neuroprotection lower the subsequent risk of childhood cerebral palsy but also the combined risk of cerebral palsy or death. The use of magnesium sulfate on clinical grounds for the prevention of cerebral palsy has become widespread. The Netherlands, Australia, New Zealand, the United Kingdom, and Canada have promulgated national guidelines for the use of magnesium sulfate to prevent cerebral palsy.