Secretaria

Seminars in Fetal & Neonatal Medicine (2007) 12, 311e317

available at www.sciencedirect.com

journal homepage: www.elsevier.com/locate/siny

Antenatal magnesium sulphate neuroprotection in thepreterm infant
´ Stephane Marret a,*, Lex W. Doyle b,c, Caroline A. Crowther d, Philippa Middleton d
a

Department of Neonatal Medicine, University Hospital, 1, rue de Germont, 76031 Rouen Cedex,France The Royal Women’s Hospital, University of Melbourne, Melbourne, Australia c Murdoch Children’s Research Institute, Melbourne, Australia d Discipline of Obstetrics and Gynaecology, Universityof Adelaide, Adelaide, Australia
b

KEYWORDS
Cerebral palsy; Infant; Magnesium sulphate; Mortality; Preterm

Summary Very preterm infants have high rates of neurological impairments anddisabilities. These rates have not diminished as the survival rates have improved. Basic science research suggests that magnesium sulphate before birth can be neuroprotective for the preterm fetus. Some, butnot all, observational studies in humans also suggest a protective effect of antenatal magnesium sulphate on cerebral palsy. Four randomised controlled trials of antenatal magnesium sulphate havereported long-term neurological effects in surviving infants, but only one of these was designed specifically to evaluate the long-term effects of treatment. These studies found that, overall, antenatalmagnesium sulphate therapy had no significant effect on paediatric mortality or neurological outcomes in the first few years of life, including cerebral palsy, but it was found to lower the rate of motorproblems at 2 years of age in one study. The role for antenatal magnesium sulphate therapy as a neuroprotective agent for the preterm fetus is not yet established. ª 2007 Elsevier Ltd. All rightsreserved.

Background
Survival and disability in very preterm infants
Survival rates for very preterm or tiny infants have increased dramatically with the advent of modern perinatal and neonatal...