title: Antenatal Magnesium and Cerebral Palsy in Preterm Infants.
abstract: OBJECTIVE
  To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP).
  
  
  METHODS
  In a randomized trial of MgSO4 or placebo in women at high risk of preterm delivery, up to 3 cranial ultrasounds were obtained in the neonatal period. Images were reviewed by at least 2 pediatric radiologists masked to treatment and other clinical conditions. Diagnoses were predefined for intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly. CP was diagnosed at 2 years of age by standardized neurologic examination.
  
  
  RESULTS
  Intraventricular hemorrhage, periventricular leukomalacia, intracerebral echolucency or echodensity, and ventriculomegaly were all strongly associated with an increased risk of CP. MgSO4 administration did not affect the risk of cranial ultrasound abnormality observed at 35 weeks postmenstrual age or later. However, for the 82% of infants born at <32 weeks gestation, MgSO4 was associated with a reduction in risk of echolucency or echodensity. The reduction in risk for echolucency explained 21% of the effect of MgSO4 on CP (P = .04), and for echodensity explained 20% of the effect (P = .02).
  
  
  CONCLUSIONS
  MgSO4 given prior to preterm delivery was associated with decreased risk of developing echodensities and echolucencies at <32 weeks gestation. However, this effect can only partially explain the effect of MgSO4 on CP at 2 years of age.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT00014989.
authors.affiliation: National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Hirtz
authors.affiliation: Biostatistics Center, The George Washington University, Washington, DC.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Weiner
authors.affiliation: Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Bulas
authors.affiliation: Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI.
authors.forename: Michael
authors.initials: M
authors.lastname: DiPietro
authors.affiliation: Division of Radiology, Arkansas Children's Hospital, Little Rock, AR.
authors.forename: Joanna
authors.initials: J
authors.lastname: Seibert
authors.affiliation: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.affiliation: Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, OH, and University of Tennessee, Memphis, TN.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, UT.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
authors.forename: Uma M
authors.initials: UM
authors.lastname: Reddy
authors.affiliation: Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.affiliation: Department of Obstetrics and Gynecology, Thomas Jefferson University and Drexel University, Philadelphia, PA.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, TX.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University, New York, NY.
authors.forename: Fergal D
authors.initials: FD
authors.lastname: Malone
authors.affiliation: Department of Obstetrics and Gynecology, Brown University, Providence, RI.
authors.forename: Marshall W
authors.initials: MW
authors.lastname: Carpenter
authors.affiliation: Department of Obstetrics and Gynecology, University of Miami, Miami, FL.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX.
authors.forename: Gary D V
authors.initials: GD
authors.lastname: Hankins
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas at San Antonio, San Antonio, TX.
authors.forename: Donald
authors.initials: D
authors.lastname: Dudley
authors.affiliation: Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
mesh_terms: D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging; D002547:Cerebral Palsy / Q000097:blood* / Q000000981:diagnostic imaging* / Q000517:prevention & control; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging; D002675:Child, Preschool; D015331:Cohort Studies; D004569:Electroencephalography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D018811:Maternal Exposure; D018696:Neuroprotective Agents / Q000627:therapeutic use; D011247:Pregnancy; D014463:Ultrasonography
chemical_list: D018696:Neuroprotective Agents; D008278:Magnesium Sulfate