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根据母婴医学会第28届年会中的报告，早产之前以静脉注射硫酸镁可以降低一半的脑性麻痹风险。
硫酸镁被常规用于先兆子痫(preeclampsia)孕妇预防抽搐以及预防早产；此外，研究者报告指出，这种治疗可以保护中度和严重的脑性麻痹。
这个多中心研究包括2,241位妇女，随机指派接受安慰剂(n = 1095)或者注射6g的硫酸镁 (n = 1041)后以每小时2g的速率输注12小时；研究中，大部分的妇女— 87% — 发生早期破水；这两组的妇女的基本特征相似，包括怀孕年纪、早产风险因素、怀有双胞胎等。
阿拉巴马大学伯明罕医学院的Dwight Rouse医师表示，追踪到婴儿2岁时，治疗组所生的婴儿发生中度到严重脑性麻痹的比率明显较低。特别的是，治疗组有20个小孩（1.9%） 发生脑性麻痹，而安慰剂组的母亲所生的小孩有3.5%发生脑性麻痹(相对风险，0.55; 95%信心区间， 0.32 – 0.95)。
分析显示，以硫酸镁治疗63位妇女可以使1个婴儿免于脑性麻痹，藉由硫酸镁预防脑性麻痹的机转尚不清楚，不过，此一成分已知可以减少血管内出血风险。
之前的一个小型研究认为补充硫酸镁可能会增加胎儿的死亡，不过，目前发表的新的随机试验，包括了有早产风险但无先兆子痫的妇女，并没有出现类似风险。
治疗组的胎儿死亡率是9.5%，安慰剂组的则是 8.5% — 之间的差异并无统计上的显著意义；再者，排除妇女的先天重大异常之后，死亡率几乎无关。
Rouse医师向Medscape Ob/Gyn & Women's Health 表示，我认为这是可靠的，至于这对临床实务的影响，产科学界必须获得共识；其他研究者也发现类似的结果，例如2003年发表于美国医学协会期刊的澳洲研究。
研究者表示，逻辑上很难有更多有关此议题的研究，目前的试验花了超过6年，涵括了全国20家以上的医学中心；此研究受国家卫生研究院赞助。
未参与此研究的北卡罗来纳大学的Roger Newman医师在主持会议时表示，实际上没有一种药物可以预防脑性麻痹，而这项研究提出一种有效的神经保护治疗。
此研究受国家卫生研究院赞助。Rouse医师和Newman医师表示无相关资金往来。
母婴医学会第28届年会：摘要1。发表于2008年1月31日。
Magnesium Sulfate Reduces Risk for Cerebral Palsy
By Laura Beil
Medscape Medical News
Intravenous magnesium sulfate supplementation before preterm delivery may cut the risk for cerebral palsy in half, according to new data presented here at the Society for Maternal-Fetal Medicine 28th Annual Meeting.
Magnesium sulfate is routinely given to prevent seizures in women with preeclampsia and to inhibit preterm labor. In addition, researchers reported here that the treatment may offer significant protection against moderate to severe cerebral palsy.
The multicenter study involved 2241 women, randomly assigned to receive either placebo (n = 1095) or a 6-g bolus of magnesium sulfate (n = 1041), followed by a further 2 g per hour for up to 12 hours. The vast majority of women — 87% — who entered the study had experienced a preterm membrane rupture. The women in the 2 groups had similar baseline characteristics, including gestational age at randomization, risk factor for preterm birth, and proportion of twins,
On follow up at age 2 years, babies born to women in the treatment group had a significantly lower rate of moderate to severe cerebral palsy, said Dwight Rouse, MD, from the University of Alabama at Birmingham School of Medicine. Specifically, 20 children, or 1.9%, had cerebral palsy in the treatment group, compared with 3.5% among the mothers who had received a placebo (relative risk, 0.55; 95% confidence interval, 0.32 – 0.95).
The analysis suggested that magnesium sulfate treatment of 63 women would spare 1 infant from cerebral palsy. The mechanism by which magnesium sulfate would prevent cerebral palsy is unclear, though the compound has been shown to reduce the risk for intravascular hemorrhage.
One small previous study had hinted that the supplement might increase the risk for fetal death. However, the results of the new randomized controlled trial presented here, involving women in danger of early delivery, but without preeclampsia, have not indicated such a risk.
The rate of fetal death was 9.5% in the treatment group and 8.5% among the women who had received a placebo — a difference that was not statistically significant. Moreover, when women with major congenital anomalies were excluded, the rates of death were almost equivocal.
"I think it's reassuring," Dr. Rouse told Medscape Ob/Gyn & Women's Health. As for what the results might mean for larger clinical practice, "the broader obstetrical community will have to come to a consensus." Other research has found similar results, including an Australian study published in the Journal of the American Medical Association in 2003.
More study of the issue would be logistically difficult, researchers said. The current trial took more than 6 years to conduct and involved more than 20 centers across the country. It was funded by the National Institutes of Health.
"There really isn't a drug to prevent cerebral palsy," said Roger Newman, MD, from the Medical University of South Carolina in Charleston, a session moderator who was not involved in the study. This study, "suggests an effective neuroprotective treatment."
The study was sponsored by the National Institutes of Health. Dr. Rouse and Dr. Newman have disclosed no relevant financial relationships.
Society for Maternal-Fetal Medicine 28th Annual Meeting: Abstract 1. Presented January 31, 2008.