The meta-analysis, published in PLOS Medicine, found that mothers given magnesium sulphate (the chemical name for Epsom salts) for foetal neuroprotection prior to preterm birth reduced the combined risk of foetal/ infant death and developing CP, by 14%.
For infants surviving birth, antenatal supplementation of magnesium sulphate to their mothers reduced the babies’ CP risk by 32%, compared with non-treatment.
The study was conducted by a multi-institutional international research team as part of the AMICABLE collaboration (Antenatal Magnesium sulphate Individual participant data international Collaboration: Assessing the Benefits for babies using the best Level of Evidence).
“Antenatal magnesium sulphate given prior to preterm birth for foetal neuroprotection prevents CP and reduces the combined risk of foetal/infant death or CP,” concluded first author Professor Caroline Crowther of Auckland University.
“Benefit is seen regardless of the reason for preterm birth, with similar effects across a range of preterm gestational ages and different treatment regimens,” she elaborated.
Significance
Babies born preterm are at greater risk of dying earlier in life than their full-term counterparts. They also have a higher likelihood of suffering from neurological impairments such as CP. These risks increase as gestational age of the infant at birth decreases, the scientists explained.
The findings suggest that CP risk and risk of death in foetuses and preterm babies could be substantially reduced using magnesium sulphate, suggested the researchers.
“Magnesium sulphate is an inexpensive, effective treatment that can reduce the burden of death and cerebral palsy in babies born very preterm.
“Antenatal magnesium sulphate for foetal neuroprotection can be recommended to be given close to planned or expected preterm birth using the smallest effective dose of 4 g with or without a 1 g/hour maintenance dose.”
If adopted on a large scale, the impact on the health of premature babies would be substantial, the researchers advocated.
“Widespread adoption worldwide of this relatively inexpensive, easy-to-administer treatment would lead to important global health benefits for infants born preterm.”
Meta-analysis details
The researchers analysed data from five randomised trials incorporating around 5,500 women. Neurological assessments from around 6,100 babies were also included.
The researchers used an individual participant data (IPD) basis to perform the meta-analysis. In an IPD, data is drawn from individual studies with similar characteristics rather than a wider general aggregation of trials used in a conventional meta-analysis. The data is then recombined and analysed.
The technique can help reduce heterogeneity, improve data quality and produce more reliable results. IPD meta-analyses “are considered to be a ‘gold standard’ of systematic review”, according to Cochrane Methods.
Source: PLOS Medicine
Volume 14, issue 10, e1002398, doi: 10.1371/journal.pmed.1002398
“Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant data meta-analysis”
Authors: Caroline A. Crowther, Lex W. Doyle, et al, for the AMICABLE Group