New York, New York, June 29, 2009 Cerebral palsy (CP) is the most prevalent chronic childhood motor disability with an estimated lifetime cost of nearly $1 million per individual. There is evidence that magnesium sulfate (MgSO4) can reduce the incidence of CP for very early preterm infants. Many thousands of pregnant women and their fetuses are exposed to MgSO4 every year in the United States for a variety of indications, and most obstetricians are comfortable with its use. Yet, there is still some controversy over whether magnesium sulfate is truly protective against CP. In three articles published in the June 2009 issue of the American Journal of Obstetrics & Gynecology, the authors shed some light on the debate.
Investigators from the Perinatology Research Branch (Division of Intramural Research), Eunice Kennedy Shriver National Institute of Child Health and Human Development, of the NIH, Bethesda, and Detroit, and the Center for Molecular Medicine and Genetics, Wayne State University, Detroit, conducted a systematic review and meta-analysis of six randomized controlled trials involving 4796 women and 5357 infants. Writing in the article, Dr. Roberto Romero and Dr. Agustin Conde-Agudelo concluded that "Antenatal magnesium sulfate should be considered for use in women at high risk of delivery before 34 weeks of gestation, mainly in those with premature rupture of membranes, labor in active phase, and planned delivery within 24 hours." They found persuasive evidence that administration of magnesium sulfate significantly reduces the risk of cerebral palsy in children at risk.
Continuing the debate, in an article summarizing a roundtable discussion at the 29th Annual Meeting of the Society for MaternalFetal Medicine, San Diego, CA, January 30, 2009, two researchers from the Division of MaternalFetal Medicine, Department of Obstetrics and Gynecology, Washington UniversitySt. Louis,, and the Division of MaternalFetal Medicine, Department
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