PLoS Medicine (Oct 2017)

Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant data meta-analysis.

  • Caroline A Crowther,
  • Philippa F Middleton,
  • Merryn Voysey,
  • Lisa Askie,
  • Lelia Duley,
  • Peter G Pryde,
  • Stéphane Marret,
  • Lex W Doyle,
  • AMICABLE Group

DOI
https://doi.org/10.1371/journal.pmed.1002398
Journal volume & issue
Vol. 14, no. 10
p. e1002398

Abstract

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BackgroundBabies born preterm are at an increased risk of dying in the first weeks of life, and those who survive have a higher rate of cerebral palsy (CP) compared with babies born at term. The aim of this individual participant data (IPD) meta-analysis (MA) was to assess the effects of antenatal magnesium sulphate, compared with no magnesium treatment, given to women at risk of preterm birth on important maternal and fetal outcomes, including survival free of CP, and whether effects differed by participant or treatment characteristics such as the reason the woman was at risk of preterm birth, why treatment was given, the gestational age at which magnesium sulphate treatment was received, or the dose and timing of the administration of magnesium sulphate.Methods and findingsTrials in which women considered at risk of preterm birth (ConclusionsAntenatal magnesium sulphate given prior to preterm birth for fetal neuroprotection prevents CP and reduces the combined risk of fetal/infant death or CP. Benefit is seen regardless of the reason for preterm birth, with similar effects across a range of preterm gestational ages and different treatment regimens. Widespread adoption worldwide of this relatively inexpensive, easy-to-administer treatment would lead to important global health benefits for infants born preterm.