Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Debate on administration of magnesium sulfate to pregnant women to prevent cerebral palsy in preterm infants

01.07.2009
June issue of American Journal of Obstetrics and Gynecology explores topic

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!
Further information:
http://www.elsevier.com

More articles from Health and Medicine:

nachricht New antibody analysis accelerates rational vaccine design
09.08.2018 | Scripps Research Institute

nachricht Distrust of power influences choice of medical procedures
01.08.2018 | Johannes Gutenberg-Universität Mainz

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

Im Focus: Lining up surprising behaviors of superconductor with one of the world's strongest magnets

Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur

What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...

Im Focus: World record: Fastest 3-D tomographic images at BESSY II

The quality of materials often depends on the manufacturing process. In casting and welding, for example, the rate at which melts solidify and the resulting microstructure of the alloy is important. With metallic foams as well, it depends on exactly how the foaming process takes place. To understand these processes fully requires fast sensing capability. The fastest 3D tomographic images to date have now been achieved at the BESSY II X-ray source operated by the Helmholtz-Zentrum Berlin.

Dr. Francisco Garcia-Moreno and his team have designed a turntable that rotates ultra-stably about its axis at a constant rotational speed. This really depends...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

2018 Work Research Conference

25.07.2018 | Event News

 
Latest News

'Building up' stretchable electronics to be as multipurpose as your smartphone

14.08.2018 | Information Technology

During HIV infection, antibody can block B cells from fighting pathogens

14.08.2018 | Life Sciences

First study on physical properties of giant cancer cells may inform new treatments

14.08.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>