Drug News
Magnesium sulfate (Epsom salt) cuts cerebral palsy risk in preemies
By Sue Mueller
Aug 28, 2008 - 9:52:07 AM

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 THURSDAY August 28, 2008 (foodconsumer.org) -- Giving an infusion of magnesium sulfate commonly known as Epsom salt just before delivery to pregnant women who were at high risk for preterm birth cut the rate of cerebral palsy in their children by half, according to a study published in the Aug. 28, 2008 issue of The New England Journal of Medicine.

Cerebral palsy is a neurological disorder that appears in infancy or early childhood and permanently affects body movement and muscle coordination, but don’t worsen over time, according to the National Institutes of Health. The causes for the condition remain unknown, but lack of oxygen during pregnancy and delivery is believed to be one of them.

Premature delivery occurs in about 13% of total births and the Centers for Disease Control and Prevention was cited by ABC News as saying that Cerebral palsy is diagnosed in some 10,000 children each year. More than 700,000 people in the U.S. are estimated to live with this condition.

Magnesium sulfate is already used to halt contractions when pregnant women get into early labor, according to ABC News. The cheap chemical is stored in every hospital delivery room and is readily available.

For the study, 2,241 women who were at risk of giving birth prematurely between 24 and 31 weeks into their pregnancies were randomly given an infusion of magnesium sulfate or a placebo. The infusion was given when delivery seemed imminent at a rate of 6 grams over 20 to 30 minutes and 2 grams per hour thereafter.

Dr. Dwight J. Rouse of the University of Alabama at Birmingham and colleagues found that moderate or severe cerebral palsy occurred 50 percent less often in those receiving the magnesium sulfate infusion than those receiving the placebo, 1.9 percent versus 3.5 percent whereas the death rates were similar in two groups.

“This is one of the most promising breakthroughs in the management of high-risk pregnancies in more than 30 years,” said Dr. John Thorp, a study co-author and McAllister distinguished professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill.

The findings were similar to the results of an Australian study 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 to examine 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 early this year, 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.

The researchers in the current study concluded that the use of magnesium sulfate should be considered for women at risk of early preterm delivery to prevent cerebral palsy in their children.