Prenatal magnesium sulfate exposure and the risk for cerebral palsy or mental retardation among very low-birth-weight children aged 3 to 5 years.
OBJECTIVE
To examine the relationship between prenatal magnesium sulfate exposure and the risk for cerebral palsy (CP) or mental retardation (MR) among very low-birth-weight (VLBW; <1500 g) children. Secondarily, to investigate the effect of prenatal magnesium sulfate exposure on VLBW infant mortality.


METHODS
Cohort study with follow-up to 1 year of age; a subset followed up to 3 to 5 years.


METHODS
Twenty-nine Georgia counties, including the 5-county Atlanta metropolitan area.


METHODS
All VLBW births (N=1097) occurring during 2 years (1986-1988); all metropolitan Atlanta VLBW neonates who survived infancy (N=519).


METHODS
Infant mortality as determined from vital statistics records. Development of CP or MR by 3 to 5 years of age among metropolitan Atlanta VLBW survivors as determined from the Metropolitan Atlanta Developmental Disabilities Surveillance Program.


RESULTS
For the entire cohort, there was no association between prenatal magnesium sulfate exposure and infant mortality (adjusted rate ratio, 1.02; 95% confidence interval [CI], 0.83-1.25). Among Atlanta-born survivors, those exposed to magnesium sulfate had a lower prevalence of CP or MR than those not exposed (CP: magnesium sulfate, 0.9%, no magnesium sulfate, 7.7%, crude odds ratio [OR], 0.11, 95% CI, 0.02-0.81; MR: magnesium sulfate, 1.8%, no magnesium sulfate, 5.8%, crude OR, 0.30, 95% CI, 0.07-1.29). Multivariable adjustment had no appreciable effect on the ORs for CP or MR, but the CIs included 1.0.


CONCLUSIONS
A reduced risk for CP, and possibly MR, among VLBW children is associated with prenatal magnesium sulfate exposure. The reduced risk for childhood CP or MR does not appear to be due to selective mortality of magnesium sulfate-exposed infants.
Schendel
D E
DE
Developmental Disabilities Branch, Division of Birth Defects and Developmental Disabilities, National Center for Environmental Health, Centers for Disease Control and Prevention, GA, USA.
Berg
C J
CJ
Yeargin-Allsopp
M
M
Boyle
C A
CA
Decoufle
P
P
D000328:Adult; D002547:Cerebral Palsy / Q000209:etiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008607:Intellectual Disability / Q000209:etiology*; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects; D012306:Risk; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use
D015149:Tocolytic Agents; D008278:Magnesium Sulfate