Magnesium Sulfate for Prevention of Cerebral Palsy: An Update, 12/2003 

Ten years ago, the UCP Research and Educational Foundation funded a pilot research project to study the use of a drug, magnesium sulfate, for the prevention of cerebral palsy in premature infants. As reported in the Foundation’s Research Fact Sheet of February 1995, the results of the pilot study did not show that the drug was effective. However, because it was a pilot study one of whose purposes was to test the research protocol in a limited number of women, the negative result of the intervention was not the final word. 

Using the experience of the pilot study, a larger, longer term study of the drug was subsequently initiated in Australia by Dr. Caroline Crowther of the University Of Adelaide, Australia, and her colleagues. They are publishing preliminary information which suggests that magnesium sulfate given intravenously to women about to deliver extremely premature babies, helped reduce brain damage including cerebral palsy, and death in those infants. The study included 1,062 women about to deliver very premature infants in 16 hospitals in Australia and New Zealand. Surviving infants were evaluated at two years of age. 

Children of women given the drug and who were born 2 months early (at 30 weeks) had 17 percent less risk of death and cerebral palsy, than women who were given placebo. The protective mechanism is not clear, but it appears the drug may help prevent bleeding in the premature infant brain—a common cause of cerebral palsy. There were no serious harmful effects of the treatment on either the mothers or children. This is a preliminary report to be published in December 2003 in the Journal of the American Medical Association (JAMA). 

Comment:
The study’s results are encouraging. The scientists caution that "widespread use of prenatal magnesium sulfate cannot be recommended solely on the basis of the present study." The review of additional data from this study and from another long term study being done in the USA will be needed before a final conclusion can be reached. 

In addition to the value of the information provided, these recent results also point out the danger of jumping to a conclusion from small, short term studies in which chance alone can influence the significance of the results. Clearly, the prior UCP pilot study showing no benefit was not the last word. These skilled investigators wisely advise caution about the conclusions to be drawn at the time from even this larger study. In the reasonably near future, when all the data are available, we should have the full information needed to know if magnesium sulfate given to women in premature labor reduces the occurrence of developmental brain damage in their premature babies. 

© UCP Research & Educational Foundation, December 2003

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