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Hirtz, Deborah G.; Weiner, Steven J.; Bulas, Dorothy; DiPietro, Michael; Seibert, Joanna; Rouse, Dwight J.; Mercer, Brian M.; Varner, Michael W.; Reddy, Uma M.; & Iams, Jay D., et al. (2015). Antenatal Magnesium and Cerebral Palsy in Preterm Infants. Journal of Pediatrics, 167(4), 834-839. PMCID: PMC4587284


Objective: To evaluate the relationship of maternal antenatal magnesium sulfate (MgSO4) with neonatal cranial ultrasound abnormalities and cerebral palsy (CP). Study design 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.


Reference Type

Journal Article

Year Published


Journal Title

Journal of Pediatrics


Hirtz, Deborah G.
Weiner, Steven J.
Bulas, Dorothy
DiPietro, Michael
Seibert, Joanna
Rouse, Dwight J.
Mercer, Brian M.
Varner, Michael W.
Reddy, Uma M.
Iams, Jay D.
Wapner, Ronald J.
Sorokin, Yoram
Ramin, Susan M.
Malone, Fergal D.
Carpenter, Marshall W.
O'Sullivan, Mary Jo
Peaceman, Alan M.
Hankins, Gary D. V.
Dudley, Donald J.
Caritis, Steve N., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network [
John M. Thorp, Jr.,