The use of antenatal magnesium sulfate for neuroprotection for infants born prematurely

Cerebral palsy occurs in three to four infants per 1000 live births. Preterm birth prior to 34 weeks’ gestation is a major risk factor. Five randomized controlled trials of antenatal magnesium sulfate (MgSO(4)) found a trend of reduced risk of cerebral palsy and mortality in preterm infants. Three meta-analyses using the data from the five randomized controlled trials, which included a total of 5235 prospectively evaluated fetuses, found that MgSO(4) given to women at risk of premature birth significantly reduced the risk of cerebral palsy by 30% without increasing the risk of perinatal or infant death. The implication for clinical practice is that MgSO(4) should be considered for use in patients at high risk of delivery before 34 weeks’ gestation.