Skip to main navigation
Skip notifications
Access to POEMs and Essential Evidence Plus will no longer be included in CMA membership as of Dec. 1, 2023.
Search
Antenatal magnesium improves neurologic outcomes in infants
Clinical Question
Does antenatal administration of magnesium to women at risk of preterm delivery improve neurologic outcomes in their infants?
Bottom line
Infants delivered to women who received antenatal magnesium to prevent preterm delivery are slightly less likely to develop cerebral palsy. 1a
Reference
Study design: Meta-analysis (randomized controlled trials)
Funding: Government
Setting: Inpatient (any location)
Synopsis
These authors searched several databases and registries to identify randomized trials of antenatal administration of magnesium to women at high risk of preterm delivery. The included trials had to have assessed neurologic outcomes in the infants. Two authors independently assessed the studies for inclusion and assessed the risk of bias in the included studies. Finally, the investigators contacted the original authors and obtained the patient-level data for pooling and analysis. They included 5 completed trials (2 are still under way) and had data on 5493 women and 6131 babies. Overall, they found no improvement in the composite outcome of infant death or cerebral palsy or in the single outcome of infant death. However, in the 4 trials designed specifically to assess neuroprotection, there was a modest reduction in the combined outcome (15% vs 17%; number needed to treat [NNT] = 43) and in cerebral palsy (5% vs 7%; NNT = 48). Maternal complications and outcomes were inconsistently reported in the trials. In the 2 studies that reported maternal complications, the rate of cesarean delivery and other secondary outcomes were comparable in the 2 treatment groups.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Comments
Good poem
I don’t do late antenatal care or deliveries
This is a sloppy study design, and that is being kind. Magnesium is present in all patients, and low levels may well have contributed to "risk of preterm delivery." Not done. "Treatment" would be expected to be more effective in deficient patients. Not done. Selection bias b/c of risk of pre-term delivery includes how many factors? How many are related to magnesium by a stretch of the imagination? Magnesium benefits are "buried" by the confusion of all these factors instead of being elegantly spot-lighted by a decent study design. And still it showed value. But the diluted results give an inaccurate picture of modest benefit when very likely it has major value for the right group.
Excellent