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Delaying Labor Can Decrease Risk of Cerebral Palsy
The New England Journal of Medicine published a report that says preterm infants born to mothers receiving intravenous magnesium sulfate — a common treatment to delay labor — are less likely to develop cerebral palsy than are preterm infants whose mothers do not receive it. The research was done by the National Institute of Health research network.
The research showed that a third of all cases of cerebral palsy are associated with preterm birth and that of those cases, there was a significant reduction in cerebral palsy among preterm infants whose mothers were given magnesium sulfate. The researchers theorized that magnesium sulfate protects against cerebral palsy because it can stabilize blood vessels, protect against damage from oxygen depletion, and protects against injury from swelling and inflammation.
The diagnosis of cerebral palsy refers to a group of neurological disorders affecting control of movement and posture and which limit activity. The brain may be injured or develop abnormally during pregnancy, birth or in early childhood. The causes of cerebral palsy are still not well understood, but this study was the largest and most comprehensive study to date. Although cerebral palsy cannot always be prevented, this treatment with magnesium sulfate is common and inexpensive and offers a treatment option for obstetricians.
Researchers conducting the study were from 20 participating research centers of the Maternal Fetal Medicine Units Network of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The study’s first author was Dwight J. Rouse, M.D., of the University of Alabama at Birmingham. Major funding was provided by NIH’s National Institute of Neurological Disorders and Stroke (NINDS).
A 1995 study by NINDS researcher Karin Nelson, M.D., and a researcher at the California Department of Health Services found that mothers of preterm infants who did not have cerebral palsy were more likely to have received magnesium sulfate than were mothers of infants who had cerebral palsy. Two later randomized studies suggested that magnesium sulfate given to pregnant women delivering prematurely might protect their infants against cerebral palsy, but their results were inconclusive.
Women at the 20 participating NICHD Maternal Fetal Medicine Unit Network sites were eligible to participate. The women were from 24 to 31 weeks pregnant and at risk for preterm delivery. When the women went into labor, they were assigned at random to receive intravenously a solution of either magnesium sulfate or a placebo. If the women in either group did not deliver within 12 hours, they were treated again if they went into labor by the 34th week of pregnancy.
Cerebral palsy was diagnosed in 41 children from 942 magnesium sulfate-treated pregnancies, as compared to 74 children from 1,002 placebo-treated pregnancies.
