Table 3 Randomized clinical studies investigating the neuroprotective effect of magnesium administered before delivery to women at risk for preterm birth (a) and administerd to children born at term after perinatal asphyxia (b)
From: Magnesium treatment for neuroprotection in ischemic diseases of the brain
Author | Study setup | Treatment arms and comedication | Individuals | Results |
|---|---|---|---|---|
A | Â | Â | Â | Â |
Schendel et al., 1996 [61] | Observational | Preterm administration for tocolysis. Dose variable, observational study | 1097 births with very low birth-weight | Reduced risk for cerebral palsy and mental retardation |
Crowther et al., 2003 [64] | Randomized | Preterm administration of 16 mmol MgSO4 followed by 4 mmol/h for 24 hours to mother vs. placebo | 1062 women in gest. week 30 or less with birth planned within 24 hours | Lower rate of pediatric mortality and cerebral palsy in the treatment group |
Marret et al., 2007 [63] | Randomized | Preterm administration of 16 mmol MgSO4 (4 g) single-dose over 30 minutes | 573 women in gest. week 33 or less with birth planned within 24 hours | Non-significant reduction of infant mortality and white matter injury |
Magpie Trial Follow-Up Collaborative Group, 2007 [66] | Randomized | Preterm administration of 16 mmol MgSO4 followed by 4 mmol/h for 24 hours to mother vs. placebo | 3283 children born before gest. week 37 | Non-significant reduction of disability after 18 months |
Rouse et al., 2008 [65] | Randomized | Preterm administration of 24 mmol MgSO4, followed by 8 mmol/h | 2241 women in gest. week 24 – 32 with birth anticipated within 24 hours | Significant reduction of cerebral palsy |
B | Â | Â | Â | Â |
Levene et al., 1995 [68] | open | MgSO4 400 mg/kg vs. 250 mg/kg | 15 full-term neonates with asphyxia | 400 mg/kg: Serum level 3,6 mmol/l, profound hypotension and respiratory depression |
250 mg/kg: Serum level 2.42 mmol/kg, no effect on herat rate, blood pressure and respiration | ||||
Groenendaal et al., 2002 [69] | Randomized | MgSO4 (250 mg/kg 30 min after birth and 125 mg/kg after 24 and 48 hours vs. placebo | 22 full-term neonates with asphyxia | No effect on pathological EEG patterns |
Ichiba et al., 2002 [70] | Randomized | MgSO4 (3 × 250 mg/kg in 24-hour intervals) vs. placebo | 34 full-term neonates with asphyxia | Less pathological CT- and abnormal EEG-findings. Higher rate of oral feeding and good short-term outcome ( at 14 days of age) in magnesium-treated children |
Gathwala et al., 2006 [71] | Randomized | MgSO4 (250 mg/kg 30 min after birth and 125 mg/kg after 24 and 48 hours vs. placebo | 40 full-term neonates with asphyxia | Safe use of magnesium. No change in heart-rate, respiratory rate of blood pressure |
Bhat et al., 2009 [72] | Randomized | MgSO4 (3 × 250 mg/kg in 24-hour intervals) vs. placebo | 40 full-term neonates with asphyxia | Less neurological abnormalities and pathological CT findings |
Gethwala et al., 2010 [73] | Randomized | MgSO4 (250 mg/kg 30 min after birth and 125 mg/kg after 24 and 48 hours vs. placebo | 40 full-term neonates with asphyxia | Less EEG- and CT abnormalities and better short-term outcome in magnesium-treated children |