Murdoch Childrens Research Institute, The Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia.
Curr Opin Pediatr. 2012 Apr;24(2):154-9. doi: 10.1097/MOP.0b013e3283504da1.
Antenatal magnesium sulfate may reduce the excessive rates of cerebral palsy in survivors of very preterm birth.
There are five randomized controlled trials of magnesium sulfate therapy given to the mother prior to very preterm birth which have reported neurological outcomes for the child, in four of which the primary aim of the trial was neuroprotection for the fetus. From meta-analysis of these randomized trials, the rate of cerebral palsy was reduced by magnesium sulfate [relative risk (RR) = 0.69; 95% confidence interval (CI) = 0.54-0.87; five trials; 6145 infants). Magnesium sulfate also lowered the rate of substantial motor dysfunction in early childhood (RR = 0.61; 95% CI = 0.44-0.85; four trials; 5980 infants). In addition, where the main aim of the trial was neuroprotection of the fetus, the rates of the combined outcomes of death or cerebral palsy (RR = 0.86; 95% CI = 0.74-0.98; four trials; 4446 infants) and death or substantial motor dysfunction (RR = 0.85; 95% CI = 0.73-0.98; three trials; 4387 infants) were significantly lower with magnesium.
On the basis of these findings several countries have now released clinical practice guidelines recommending antenatal magnesium sulfate prior to very preterm birth.
产前硫酸镁治疗可能会降低极早产儿脑瘫的发生率。
有五项关于母亲在极早产分娩前接受硫酸镁治疗的随机对照试验报告了儿童的神经结局，其中四项试验的主要目的是为胎儿提供神经保护。对这些随机试验的荟萃分析显示，硫酸镁治疗降低了脑瘫的发生率[相对风险（RR）=0.69；95%置信区间（CI）=0.54-0.87；五项试验；6145 名婴儿]。硫酸镁还降低了儿童早期严重运动功能障碍的发生率（RR=0.61；95%CI=0.44-0.85；四项试验；5980 名婴儿）。此外，在试验的主要目的是为胎儿提供神经保护的情况下，死亡或脑瘫的联合结局发生率（RR=0.86；95%CI=0.74-0.98；四项试验；4446 名婴儿）和死亡或严重运动功能障碍的发生率（RR=0.85；95%CI=0.73-0.98；三项试验；4387 名婴儿）也显著降低。
基于这些发现，一些国家现在已经发布了临床实践指南，建议在极早产分娩前使用产前硫酸镁。
