title: Magnesium for newborns with hypoxic-ischemic encephalopathy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Magnesium may have a role in neuroprotection in neonatal hypoxic-ischemic encephalopathy (HIE). The objective of this study was to systematically review the efficacy and safety of postnatal magnesium therapy in newborns with HIE.
  
  
  METHODS
  MEDLINE, EMBASE, CINAHL and CCRCT were searched for studies of magnesium for HIE. Randomized controlled trials that compared magnesium to control in newborns with HIE were selected. The primary outcome was a composite outcome of death or moderate-to-severe neurodevelopmental disability at 18 months. When appropriate, meta-analyses were conducted using random effects model and risk ratios (RRs) and 95% confidence intervals (CIs) were calculated.
  
  
  RESULTS
  Five studies with sufficient quality were included. There was no difference in the primary outcome between the magnesium and the control groups (RR 0.81, 95% CI 0.36 to 1.84). There was significant reduction in the unfavorable short-term composite outcome (RR 0.48, 95% CI 0.30 to 0.77) but no difference in mortality (RR 1.39, 95% CI 0.85 to 2.27), seizures (RR 0.84, 95% CI 0.59 to 1.19) or hypotension (RR 1.28, 95% CI 0.69 to 2.38) between the magnesium and the control groups.
  
  
  CONCLUSIONS
  The improvement in short-term outcomes without significant increase in side effects indicate the need for further trials to determine if there are long-term benefits of magnesium and to confirm its safety. Mortality was statistically insignificant between the magnesium and the control groups. However, the trend toward increase in mortality in the magnesium group is a major clinical concern and should be monitored closely in future trials.
authors.affiliation: Department of Pediatrics, Winnipeg Regional Health Authority, WS012 Women's Hospital, Winnipeg, MB, Canada. mtagin@hsc.mb.ca
authors.forename: M
authors.initials: M
authors.lastname: Tagin
authors.forename: P S
authors.initials: PS
authors.lastname: Shah
authors.forename: K-S
authors.initials: KS
authors.lastname: Lee
mesh_terms: D002658:Developmental Disabilities / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D007231:Infant, Newborn; D017616:Magnesium Compounds / Q000627:therapeutic use*
chemical_list: D017616:Magnesium Compounds