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Published on: November 20, 2015
Treatment with magnesium sulphate in pre-term birth: a systematic review and meta-analysis of observational studies
H T Wolf1, H K Hegaard, G Greisen
1Department of Abdominal Surgery, Nykøbing Falster Sygehus, Denmark. trapwolf@gmail.com
Insights
Magnesium sulphate given to mothers during premature birth significantly reduces infant mortality and the risk of cerebral palsy. Further research is needed to determine optimal dosage and timing for this intervention.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Neurology
Background:
- Premature birth is a leading cause of infant mortality and cerebral palsy.
- Identifying interventions to mitigate these risks is crucial for neonatal outcomes.
Purpose of the Study:
- To investigate the association between antenatal magnesium sulphate treatment and infant mortality and cerebral palsy.
- To conduct a meta-analysis of observational studies examining this association.
Main Methods:
- A systematic literature search was performed in Cochrane Library, EMBASE, and PubMed up to October 2010.
- Included 11 observational studies, with data extracted independently by two authors.
- Meta-analysis was used to pool data and assess the risk reduction.
Main Results:
- Magnesium sulphate treatment was associated with a significant reduction in infant mortality (RR 0.73; 95% CI 0.61-0.89).
- A significant reduction in the risk of cerebral palsy was also observed (OR 0.64; 95% CI 0.47-0.89).
Conclusions:
- Antenatal magnesium sulphate administration appears to offer significant health benefits for infants born prematurely.
- Optimal dosing and timing require further investigation, potentially through large-scale pragmatic clinical trials.
Abstract:
Premature birth increases a child's risk of cerebral palsy and death. The aim of this work is to investigate the association between treatment with magnesium sulphate during premature deliveries and infants' cerebral palsy and mortality through a meta-analysis of observational studies. A comprehensive search of the Cochrane Library, EMBASE and the PubMed database from their inceptions to 1 October, 2010 using the keywords 'magnesium sulphate, children/infant/pre-term/premature and cerebral palsy/mortality/morbidity/adverse effects/outcome' identified 11 reports of observational studies. Two authors working independently extracted the data. A meta-analysis of the data found an association between magnesium sulphate treatment and a significantly reduced risk of mortality (RR 0.73; 95% CI 0.61-0.89) and cerebral palsy (OR 0.64; 95% CI 0.47-0.89). Antenatal treatment with magnesium sulphate during premature deliveries seems to be associated with health benefits for the infants. The effective dose and timing, however, is not defined and given the lack of mechanistic understanding of the effect of MgSO(4), a reasonable alternative is a large-scale pragmatic clinical trial.
