THURSDAY JAN 31 2008 (Foodconsumer.org) -- Preterm birth would result in fewer cases of cerebral palsy if pregnant women at higher risk of preterm birth receive an infusion of magnesium sulfate) just prior to delivery, a new U.S. study suggests.

Cerebral palsy is a serious condition resulting from brain damage that occurs before, during and after birth. People with this condition cannot move normally.  At least one-third or even 45 to 50 percent of the cases happen in babies born prematurely.

Magnesium sulfate or Epsom salt is a cheap drug that is readily available in every delivery room where it is stored for other purposes and may be used to prevent cerebral palsy in preemies if doctors believe the evidence the current study provided is strong enough.

The study led by Dr. John Thorp, a professor of obstetrics and gynecology at the University of North Carolina in Chapel Hill and colleagues involved 2,241 women at 20 sites in the United States who were at high risk of giving birth prematurely - 6 to 13 weeks earlier than expected.

In the study, one group of women was given an intravenous infusion of magnesium sulfate solution and another group a placebo.

The researchers found infants born to mothers who received the drug were less likely to suffer severe and moderate cerebral palsy than those who did not, 1.9 percent versus 3.5 percent.

There were no obvious adverse effects observed.  The difference in the risk of infant death was not significant between women who received magnesium sulfate and those who did not.

The results scheduled to be presented Thursday at the Society for Maternal-Fetal Medicine annual meeting in Dallas differed somewhat from what was found in an early study by Australian researchers, which was reported in the November 26, 2003 issue of The Journal of the American Medical Association (JAMA).

According to the report, Caroline A. Crowther, M.D., of The University of Adelaide, South Australia, and colleagues conducted a study similar to the current study to see how magnesium sulfate affects the outcomes of death or neurosensory impairments and disabilities such as cerebral palsy.

Crowther and colleagues conducted the trial in 1,062 women who delivered their babies younger than 30 weeks gestation between Feb 1996 and September 2000 at 16 hospitals in Australia and New Zealand.

For the trial, women were randomly assigned an intravenous infusion of magnesium sulfate solution or sodium chloride solution (as placebo) for 20 minutes followed by a maintenance infusion for up to 24 hours. The babies were followed up at the age of 2.

The researchers found the total pediatric mortality, cerebral palsy in survivors and combined death or cerebral palsy were not significantly different between the two groups although there was seemingly a 17 percent reduction in the risks.

However, cases of substantial gross motor dysfunction and combined death or substantial gross motor dysfunction were statistically significantly reduced by 49 percent and 25 percent respectively.

The current study did not provide more results to show that use of magnesium sulfate could help reduce the risk of cerebral palsy as significantly as previously believed. It's unlikely doctors would adopt this treatment based on these studies, some experts suggested.
 
Geeta Swamy, a maternal-fetal medicine specialist and assistant professor at Duke University Medical Center, was cited by USA Today, as saying that although the Thorp's study did not show any serious adverse effects, a handful of women each year suffer bad reactions to magnesium sulfate such as respiratory problems.

http://www.cdc.gov/NCBDDD/dd/cp3.htm#common