title: Use of magnesium sulfate before 32 weeks of gestation: a European population-based cohort study.
abstract: The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4in women delivering before 32 weeks of gestation by indication.
  
  
  
  We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires. The study population comprised 720 women with severe pre-eclampsia, eclampsia or HELLP and 3658 without pre-eclampsia delivering from 24 to 31 weeks of gestation in 119 maternity units with 20 or more very preterm deliveries per year.
  
  
  
  Among women with severe pre-eclampsia, eclampsia or HELLP, 255 (35.4%) received MgSO4before delivery. 41% of units reported use of MgSO4whenever possible for pre-eclampsia and administered MgSO4more often than units reporting use sometimes. In women without pre-eclampsia, 95 (2.6%) received MgSO4. 9 units (7.6%) reported using MgSO4for fetal neuroprotection whenever possible. In these units, the median rate of MgSO4use for deliveries without severe pre-eclampsia, eclampsia and HELLP was 14.3%. Only 1 unit reported using MgSO4as a first-line tocolytic. Among women without pre-eclampsia, MgSO4use was not higher in women hospitalised before delivery for preterm labour.
  
  
  
  Severe pre-eclampsia, eclampsia or HELLP are not treated with MgSO4as frequently as evidence-based medicine recommends. MgSO4is seldom used for fetal neuroprotection, and is no longer used for tocolysis. To continuously lower morbidity, greater attention to use of MgSO4is needed.
authors.affiliation: Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen University Hospital, Denmark.
authors.forename: H T
authors.initials: HT
authors.lastname: Wolf
authors.affiliation: Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen University Hospital, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Huusom
authors.affiliation: Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen University Hospital, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Weber
authors.affiliation: Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Piedvache
authors.affiliation: Department of Obstetrics, University Hospital, Philipps University, Marburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schmidt
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Stockholm, Sweden.|Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Norman
authors.affiliation: Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Zeitlin
mesh_terms: D000328:Adult; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D015331:Cohort Studies; D004461:Eclampsia / Q000188:drug therapy*; D005060:Europe; D019317:Evidence-Based Medicine; D005260:Female; D005865:Gestational Age; D019983:Guideline Adherence / Q000706:statistics & numerical data; D017359:HELLP Syndrome / Q000188:drug therapy*; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011225:Pre-Eclampsia / Q000188:drug therapy*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D002121:Calcium Channel Blockers; D008278:Magnesium Sulfate
keywords: PREVENTIVE MEDICINE