Dpartment of Obstetrics and Gynecology, Washington University in St Louis, St Louis, Missouri, USA.
Curr Opin Obstet Gynecol. 2010 Apr;22(2):122-7. doi: 10.1097/GCO.0b013e3283372312.
The purpose of the present review is to review the literature regarding the use of antenatal magnesium sulfate (MgSO4) for fetal neuroprotection and prevention of cerebral palsy in women at risk of preterm delivery.
Cerebral palsy is a nonprogressive disorder of movement and posture and a leading cause of childhood disability. Preterm birth is a major risk factor for the development of cerebral palsy; gestational age at delivery has an inverse relationship to the risk of cerebral palsy. Observational studies over the past 15 years have suggested a possible protective role for MgSO4. In some studies, children born preterm who were exposed prenatally to MgSO4 for obstetric indications such as seizure prophylaxis or tocolysis had decreased rates of cerebral palsy as compared with children born preterm to women who were not exposed to MgSO4. Randomized trials have been conducted to test the hypothesis that maternal MgSO4 exposure had neonatal neuroprotective effects. These studies included women thought to be at risk of preterm delivery within 24 h. The largest of these studies, published in 2008 by Dr Rouse et al., included more than 2000 women and found a decreased rate of moderate-to-severe cerebral palsy in surviving children born to women treated with MgSO4.
MgSO4 treatment in women at high risk for preterm birth may reduce the risk of cerebral palsy in children who survive.
本综述的目的是回顾有关产前硫酸镁（MgSO4）用于有早产风险的妇女胎儿神经保护和预防脑瘫的文献。
脑瘫是一种运动和姿势的进行性障碍，也是儿童残疾的主要原因。早产是脑瘫发展的主要危险因素；分娩时的胎龄与脑瘫的风险呈反比。过去 15 年的观察性研究表明，MgSO4 可能具有保护作用。在一些研究中，与未接触 MgSO4 的孕妇所生的早产儿相比，因癫痫预防或保胎而接受产前 MgSO4 治疗的产科指征早产儿脑瘫发生率降低。已经进行了随机试验来检验母体 MgSO4 暴露具有新生儿神经保护作用的假设。这些研究包括在 24 小时内有早产风险的妇女。这些研究中规模最大的一项由 Rouse 博士等人于 2008 年发表，纳入了 2000 多名妇女，发现接受 MgSO4 治疗的妇女所生的存活儿童中，中重度脑瘫的发生率降低。
在有早产高风险的妇女中使用 MgSO4 治疗可能会降低存活儿童脑瘫的风险。
