Cerebral palsy (CP) is the most common chronic movement disorder in children, and the estimated lifetime cost per person is close to US $1 million. There is evidence that MgSO3 can reduce the incidence of CP in very early preterm infants. In the United States, thousands of pregnant women and their fetuses are exposed to MgSO4 for various indications every year, and most obstetricians are comfortable with its use. However, there are still some disputes about whether MgSO3 can really prevent CP.
In the United States, thousands of pregnant women and their fetuses are exposed to MgSO4 for various indications every year, and most obstetricians are comfortable with its use. However, there are still some disputes about whether MgSO3 can really prevent CP. In three articles published in the American Journal of Obstetrics and Gynecology in June 2009, the author gave some explanations to this dispute.
Researchers from the National Institutes of Health, Bethesda and the Unis Kennedy Shriver National Institute of Child Health and Human Development in Detroit and the Perinatal Research Branch (internal research department) of the Molecular Medicine and Genetics Center of Wayne State University in Detroit conducted a systematic review and meta-analysis of six randomized controlled trials, involving 4796 women and 5357 infants. Dr. Roberto Romero and Agustin Conde Agudelo concluded in the article: "Prenatal MgSO3 should be considered for women with high risk of delivery before 34 weeks of pregnancy, mainly those with premature rupture of fetal membrane, active labor process and planned delivery within 24 hours." They found convincing evidence that administration of MgSO3 significantly reduced the risk of cerebral palsy in high-risk children.
To continue the debate, in an article summarizing the round table discussion at the 29th annual meeting of the Maternal and Fetal Medical Association held in San Diego on January 30, 2009, two researchers from the Department of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, San Diego. Louis and the Department of Maternal and Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco cited the advantages and disadvantages of MgSO3 used to prevent CP. In a spirited conversation, each of them talked about the available experimental and observational research, as well as their advantages and disadvantages.
Alison G. Cahill, M.D., MSCI, and Aaron B. Caughey, M.D., who participated in the round table, observed that "despite carefully designed and executed research, the answer to the question
whether evidence-based medicine supports the use of magnesium as neuroprotection in all preterm births is still unclear."
Dwight J. Rouse, MD, of the Center for Women's Reproductive Health at the University of Alabama, Birmingham, provided his clinical perspective on the use of MgSO4 to prevent cerebral palsy. He pointed out that "three large randomized placebo-controlled trials on prenatal MgSO3 (MgSO4) to protect fetal nerves have been conducted recently. The results of these trials provide strong support for using MgSO4 to reduce the risk of cerebral palsy in premature survivors. In the United States, using MgSO4 to protect fetal nerves may prevent 1000 cases of cerebral palsy every year."
