Magnesium May Reduce Risks to Children Born Prematurely

Healthnotes Newswire (February 5, 2004)—The increased risk of infant mortality and cerebral palsy associated with premature birth can be prevented to some extent by giving the mother intravenous magnesium sulfate at the onset of labor, according to a new study in theJournal of the American Medical Association (2003;290:2669–76).

Infants born before 37 weeks’ gestation are considered premature, and the risk of dying at birth increases with each week that the child is born early. The primary difficulty with premature infants is poor lung development and the inability to breathe on their own. Premature children also tend to have higher rates of lung, intestinal, immune system, and neurological problems. Preterm labor not associated with rupture of the membranes or bleeding can be stopped with bed rest and proper hydration in up to 50% of cases. However, if the mother is bleeding or her amniotic sac has ruptured, little can be done to stop the delivery. Factors that contribute to premature birth are largely unknown.

In the new study, 1,062 pregnant women who had gone into labor with fetuses less than 30 weeks’ gestation were randomly assigned to receive either intravenous (IV) magnesium sulfate (0.5 g/ml), or placebo (sodium chloride), in addition to standard medical care. All women received 8 ml of their respective treatment fluid over the first 20 minutes and then 2 ml per hour until delivery or for 24 hours, whichever came first. All children were periodically monitored until they reached the age of two years. Mortality rates were documented and surviving children were assessed for development of cerebral palsy and for motor function (walking, standing). Each child was also assessed for vision, hearing, and psychological abnormalities.

A significant reduction was observed in the magnesium group, compared with the placebo group, in the proportion of children at the age of two years who had substantial motor abnormalities. Total mortality and the risk of developing cerebral palsy were also lower in the magnesium group; however, these results did not reach statistical significance. Despite the lack of statistical significance, the authors of the study suggested that these benefits may still be clinically important. No significant vision or hearing difference was observed between groups.

Previous studies have found that IV administration of magnesium to mothers may be useful in reducing the risk of infant death and cerebral palsy. Because some neurological problems do not develop until after the age of two years, it is possible that IV magnesium may provide other long-term benefits after the age of two. More research is necessary to determine if this would be true.