Aller à la navigation principale
Skip notifications
À compter du 1er décembre 2023, l’accès à POEMs et à Essential Evidence Plus ne fera plus partie des avantages offerts aux membres de l’AMC.
Search
Magnesium sulfate reduces the risk of cerebral palsy in offspring when given to women prior to preterm birth
Question clinique
Does magnesium sulfate reduce the risk of cerebral palsy in offspring when given to women at imminent risk of preterm birth?
L’Essentiel
The results of this meta-analysis (6 trials, 6037 infants) comparing magnesium sulfate (MgSO4) with placebo when given prior to preterm birth are sufficient to assert that MgSO4 reduces the risk for cerebral palsy in children born preterm across a wide range of gestational ages without documented adverse effects. Further research should compare regimens based on dosing and timing. 1a
Référence
Plan de l'etude: Meta-analysis (other)
Financement: Foundation
Cadre: Inpatient (any location) with outpatient follow-up
Sommaire
For this meta-analysis the authors identified 6 randomized controlled trials (N = 5917 women and 6037 infants) conducted between 2002 and 2019. All included studies compared MgSO4 with placebo when given prior to preterm birth. Dosing regimens of MgSO4 varied among studies, with initial intravenous boluses of 4 grams to 6 grams followed by maintenance doses of 0 to 3 grams per hour. The incidence of cerebral palsy (any) was 3.4% among treated children versus 5.0% among placebo group (relative risk [RR] 0.68; 95% CI 0.54 - 0.85). The authors conducted a trial sequential analysis (TSA) and found a TSA-adjusted RR of 0.69 (0.48 - 0.97), with an author-calculated number needed to treat (NNT) of 63 for children born at 32 to 37 weeks' gestation. They found no heterogeneity among trials. Further analysis showed that there was benefit to treatment across a range of gestational ages. The authors found that the NNT to prevent one case of moderate to severe cerebral palsy among infants born at less than 28 weeks' gestation (n = 2 studies) was 32, with a wide confidence interval (18 - 121). Analysis of secondary outcomes showed no indications of harms associated with MgSO4
Reviewer
Linda Speer, MD
Professor and Chair, Department of Family Medicine
University of Toledo
Toledo, OH
Commentaires
Mg+2
I don't do obstetrics anymore, but it is so nice to find low tech solutions that can be easily instituted.
No
Could be significant as general recommendations for pregnancy
relevant issue
importance of something simple as health intervention