Magnesium sulfate and fetal neuroprotection: overview of clinical evidence

Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly redu...

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Main Authors: Clément Chollat, Stéphane Marret
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Neural Regeneration Research
Subjects:
Online Access:http://www.nrronline.org/article.asp?issn=1673-5374;year=2018;volume=13;issue=12;spage=2044;epage=2049;aulast=Chollat
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author Clément Chollat
Stéphane Marret
author_facet Clément Chollat
Stéphane Marret
author_sort Clément Chollat
collection DOAJ
description Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly reduces the risk of cerebral palsy at two years. Through secondary analyses of randomized controlled trials and other original clinical studies, this state-of-the-art review highlights the absence of serious adverse effects in both pregnant women and neonates, as well as the impact of maternal body mass index and preeclamptic status on the maternal and neonatal magnesium levels, which could influence the magnitude of the neuroprotective effect. Although antenatal magnesium sulfate is a cost-effective strategy, some practice surveys have demonstrated that the use of magnesium sulfate is not sufficient and that its use is heterogeneous, differing among different maternity wards. Since 2010, an increasing number of obstetrical societies have recommended its use to improve the neurological outcomes of preterm infants, especially the International Federation of Gynecology and Obstetrics and World Health Organization in 2015, and France in 2017. Considering the neuroprotective impact of magnesium sulfate when administered before delivery, postnatal administration should be considered, and its effects should be assessed using randomized controlled trials.
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spelling doaj.art-d96ef0fbe2b0454985b9124d448445f62022-12-21T19:06:53ZengWolters Kluwer Medknow PublicationsNeural Regeneration Research1673-53742018-01-0113122044204910.4103/1673-5374.241441Magnesium sulfate and fetal neuroprotection: overview of clinical evidenceClément ChollatStéphane MarretAntenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly reduces the risk of cerebral palsy at two years. Through secondary analyses of randomized controlled trials and other original clinical studies, this state-of-the-art review highlights the absence of serious adverse effects in both pregnant women and neonates, as well as the impact of maternal body mass index and preeclamptic status on the maternal and neonatal magnesium levels, which could influence the magnitude of the neuroprotective effect. Although antenatal magnesium sulfate is a cost-effective strategy, some practice surveys have demonstrated that the use of magnesium sulfate is not sufficient and that its use is heterogeneous, differing among different maternity wards. Since 2010, an increasing number of obstetrical societies have recommended its use to improve the neurological outcomes of preterm infants, especially the International Federation of Gynecology and Obstetrics and World Health Organization in 2015, and France in 2017. Considering the neuroprotective impact of magnesium sulfate when administered before delivery, postnatal administration should be considered, and its effects should be assessed using randomized controlled trials.http://www.nrronline.org/article.asp?issn=1673-5374;year=2018;volume=13;issue=12;spage=2044;epage=2049;aulast=Chollatmagnesium sulfate; preterm birth; neuroprotection; cerebral palsy; neurodevelopment; international recommendations; clinical studies; meta-analysis; preeclampsia; cost-effectiveness
spellingShingle Clément Chollat
Stéphane Marret
Magnesium sulfate and fetal neuroprotection: overview of clinical evidence
Neural Regeneration Research
magnesium sulfate; preterm birth; neuroprotection; cerebral palsy; neurodevelopment; international recommendations; clinical studies; meta-analysis; preeclampsia; cost-effectiveness
title Magnesium sulfate and fetal neuroprotection: overview of clinical evidence
title_full Magnesium sulfate and fetal neuroprotection: overview of clinical evidence
title_fullStr Magnesium sulfate and fetal neuroprotection: overview of clinical evidence
title_full_unstemmed Magnesium sulfate and fetal neuroprotection: overview of clinical evidence
title_short Magnesium sulfate and fetal neuroprotection: overview of clinical evidence
title_sort magnesium sulfate and fetal neuroprotection overview of clinical evidence
topic magnesium sulfate; preterm birth; neuroprotection; cerebral palsy; neurodevelopment; international recommendations; clinical studies; meta-analysis; preeclampsia; cost-effectiveness
url http://www.nrronline.org/article.asp?issn=1673-5374;year=2018;volume=13;issue=12;spage=2044;epage=2049;aulast=Chollat
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