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Magnesium supplementation and perinatal hypoxia: outcome of a parallel group randomised trial in pregnancy
V Harrison1, S Fawcus, E Jordaan
1School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa. costello@netactive.co.za
Objective:
To determine the effects of magnesium supplementation in pregnancy on the incidence of hypoxic-ischaemic encephalopathy (HIE).
Design:
A randomised double-blind placebo-controlled study.
Setting:
A Midwife Obstetric Unit and its two referral hospitals in Cape Town, South Africa.
Population:
A group of 4494 black pregnant women of low socio-economic status.
Method:
Mothers, from the time of booking until delivery, were randomised to receive two identical tablets daily, containing either 128 mg slow-release magnesium stearate or lactose sugar.
Main Outcome Measures:
Primary: The incidence of HIE. Secondary: The incidence of fetal heart rate decelerations, term Stillbirths, Low Apgar Scores, Meconium Aspiration Pneumonia.
Results:
The incidence of HIE (0.9%) was considerably less than anticipated (2%). There were 22 infants in the placebo group and 15 infants in the supplemented group (P = 0.279). The difference was not significant. Secondary outcomes such as late fetal heart rate decelerations (P = 0.002) and term stillbirths (P = 0.016) were reduced significantly in the supplemented group, but this finding needs further substantiation.
Conclusions:
Magnesium supplementation did not reduce the incidence of HIE significantly, probably because the study was underpowered and compliance was relatively poor.
