Protection of the Developing Brain of Very Low Birth Weight Infants, 2/1995 

Very low birth weight (3.3 lbs. or less) is an important risk factor for damage to the infant's developing brain. Nationally, 45,000 infants are born each year with a birth weight of 3.3 lbs or less. Of these, 85% survive. Of the survivors, 5-15% develop cerebral palsy. Thus, measures to protect the brain of the infant born with a very low birth weight can be of significance in reducing the occurrence of cerebral palsy. The Foundation has designated as areas of priority: research to prevent low birth weight and prematurity; and the development of methods to protect the low birth weight infant's brain. 

A recent article in the journal Pediatrics¹ presents information which may have significance for the protection of the brain of infants born with very low birth weights. 

The authors report on the use of magnesium sulfate, sometimes given to mothers shortly before delivery as a treatment for premature labor and/or toxemia brought on by pregnancy. Children with birth weights of less than 3.3 lbs and with moderate to severe disabilities due to cerebral palsy were compared to children of similar very low birth weights who did not develop these disabilities. The authors report that in women who gave birth to very low birth weight babies, there was a significant decrease in the occurrence of moderate to severe cerebral palsy when magnesium sulfate was administered to the mother prior to delivery. The marked reduction in the rate of occurrence of cerebral palsy was seen regardless of the medical reason for early delivery. They suggest that magnesium is protective to the very low birth weight infant's brain.  

This study is based on an analysis of previous records (a "retrospective" study) by a scientist in the National Institute of Neurological Disorders and Stroke working with a scientist in the California Birth Defects Monitoring Program, the latter an organization receiving research grant support from our Foundation. However exciting the results of the study, they must be interpreted with caution. Retrospective studies rarely "prove" anything; they usually serve to develop an idea which is than tested in a "prospective" study of new cases in a controlled clinical trial done under exacting conditions. The Foundation is working with the authors of the study to develop and initiate the needed clinical trial to test the hypothesis that the use of magnesium sulfate before early delivery may help in protecting the brain of very low birth weight infants.  

In conclusion, at this time the results of the study reported in Pediatrics are exciting and provocative, but not conclusive. With the Foundation's assistance, they will be put to the test.  

Nelson, K.B., Grether, J.K., "Can magnesium sulfate reduce the risk of cerebral palsy in very low birth weight infants?" Pediatrics 1995, 95 (2). 

© UCP Research & Educational Foundation, February 1995

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