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 Maternal–Fetal Medicine, San Diego, CA, January 30, 2009, two researchers from the Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Washington University–St. Louis,, and the Division of Maternal–Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California–San Francisco, enumerate the pros and cons of magnesium sulfate use for CP prevention. In a spirited conversation, they each talk about the available trials and observational studies and the strengths and weaknesses of each.
Participating in the roundtable, Alison G. Cahill, MD, MSCI, and Aaron B. Caughey, MD, PhD, observe, "Despite well-designed and executed studies, the answer to the question of whether evidence-based medicine supports the use of magnesium for neuroprophylaxis in all preterm pregnancies remains unclear."
Dwight J. Rouse, MD, of the Center for Women's Reproductive Health, University of Alabama at Birmingham, offers his clinical opinion on the use of MgSO4 to prevent cerebral palsy. He notes that "three large, randomized placebo-controlled trials of antenatal magnesium sulfate (MgSO4) for fetal neuroprotection have recently been conducted and reported. The results of these trials provide strong support for the utilization of MgSO4 to lower the risk of cerebral palsy among the survivors of early preterm birth. In the United States, the use of MgSO4 for fetal neuroprotection has the potential to prevent 1000 cases of handicapping cerebral palsy annually."
The articles are:"Antenatal Magnesium Sulfate for the Prevention of Cerebral Palsy in Preterm Infants
"Magnesium for Neuroprophylaxis: Fact or Fiction?" by Alison G. Cahill, MD, MSCI, and Aaron B. Caughey, MD, PhD
"Magnesium Sulfate for the Prevention of Cerebral Palsy" by Dwight J. Rouse, MD
These contributions appear in the American Journal of Obstetrics & Gynecology, Volume 200, Issue 6 (June 2009) published by Elsevier.
Pamela Poppalardo | EurekAlert!
Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences
What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy