Preterm birth, defined as delivery before 37 weeks of pregnancy, remains a significant challenge for both doctors and families, affecting about 15 million babies worldwide each year. Babies born prematurely face a higher risk of serious health issues, including breathing difficulties, infections, and brain development problems. While medical advances have improved the survival rates of these infants, long-term developmental issues such as cerebral palsy are still a concern.
One of the promising treatments for protecting the brain of a preterm baby is magnesium sulphate. This medication has been widely studied and is now commonly recommended for women at risk of preterm birth to reduce the chances of their babies developing cerebral palsy, a condition that affects movement, posture, and coordination. Findings from recent research provides insights into how magnesium sulphate works and why it’s beneficial for babies at risk of being born early.
When babies are born before their bodies and organs are fully developed, especially their lungs and brain, they are at greater risk for a host of health complications. Some common complications of premature birth include:
- Respiratory Distress Syndrome (RDS): Difficulty breathing due to underdeveloped lungs.
- Intraventricular Hemorrhage (IVH): Bleeding in the brain, which can lead to brain damage.
- Necrotizing Enterocolitis (NEC): A severe intestinal issue that can be life-threatening.
- Retinopathy of Prematurity (ROP): Eye problems that can result in blindness.
- Chronic Lung Disease: Known as bronchopulmonary dysplasia (BPD), which affects long-term breathing.
- Cerebral Palsy: A permanent brain injury that affects a child’s ability to move and maintain balance.
How Magnesium Sulphate Can Help
A systematic review published in 2024, led by Emily Shepherd and others, has further solidified the importance of magnesium sulphate for women at risk of delivering preterm. The study found that administering magnesium sulphate to pregnant women significantly reduces the risk of cerebral palsy in babies born before 34 weeks of gestation.
Key Findings from the Research:
- Reduces the Risk of Cerebral Palsy: Magnesium sulphate reduced the risk of cerebral palsy in preterm babies by around 29%. This means that for every 60 women treated with magnesium sulphate, one case of cerebral palsy was prevented.
- Fewer Cases of Death or Cerebral Palsy: The combination of death or cerebral palsy was reduced by 13%. This means fewer infants suffered these severe outcomes when their mothers received magnesium sulphate.
- Possible Reduction in Brain Bleeding (IVH): The study found moderate evidence that magnesium sulphate reduced the occurrence of severe brain hemorrhages, which can lead to long-term disabilities.
- Safe for Mothers: The medication was generally well-tolerated by mothers, though it did have some side effects, such as nausea or a warm flushing sensation, but these were typically mild.
Although the exact mechanism of how magnesium sulphate protects the brain isn’t fully understood, researchers believe that it helps by stabilizing the brain cells and reducing harmful inflammation. This protection appears to be most beneficial when given to women who are likely to deliver before 34 weeks. The medicine is usually administered through an IV drip and works best if given shortly before delivery.
What About Long-Term Effects?
The study also examined whether magnesium sulphate had any long-term benefits for children beyond their early years. While the reduction in cerebral palsy and death is clear for babies up to two years old, the evidence is less certain about its impact on school-aged children. More research is needed to fully understand the long-term effects.
Common Concerns and Side Effects
Some mothers may worry about the side effects of receiving magnesium sulphate. While it’s important to be aware of these, the research shows that the benefits for the baby far outweigh the risks. Common side effects include feeling flushed or warm, mild nausea. In rare cases, the treatment may need to be stopped if side effects become severe, but this happens in less than 5% of cases
For families facing the prospect of preterm birth, magnesium sulphate offers hope in reducing the long-term impact on their child’s development. While preterm birth can still carry many risks, including complications that may need careful monitoring, the ability to reduce the risk of cerebral palsy significantly is a powerful tool in neonatal care.
As medical research continues to advance, treatments like this one will hopefully become even more effective, and more babies will be able to overcome the challenges of being born early. If you’re expecting a baby and facing the possibility of preterm labor, it’s important to discuss magnesium sulphate treatment with your healthcare provider to understand how it might help protect your baby’s future. The drug itself is shockingly low – costing approximately £5 (~$6.50) per dose in England. The treatment requires clinical admission with experienced staff to administer the drug safely to the mother.
Citation: Shepherd ES, Goldsmith S, Doyle LW, Middleton P, Marret S, Rouse DJ, Pryde P, Wolf HT, Crowther CA. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database of Systematic Reviews 2024, Issue 5. Art. No.: CD004661. DOI: 10.1002/14651858.CD004661.pub4.
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