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Major placebo-controlled randomized trials of treatment of pregnant women with magnesium sulfate for neuroprotection of offspring

Major placebo-controlled randomized trials of treatment of pregnant women with magnesium sulfate for neuroprotection of offspring
Trial Number of subjects Gestational age at randomization (weeks) Magnesium sulfate dose Death Cerebral palsy Composite outcome Other outcomes
ACTOMgSO4 1062 <30 4 g loading dose followed by 1 g/hour for maximum of 24 hours Total pediatric mortality:
  • 13.8 versus 17.1%
  • RR 0.83
  • 95% CI 0.64-1.09
Cerebral palsy:
  • 6.8 versus 8.2%
  • RR 0.83
  • 95% CI 0.54-1.27
Death or cerebral palsy:
  • 19.8 versus 24.0%
  • RR 0.83
  • 95% CI 0.66-1.03
Substantial gross motor dysfunction:
  • 3.4 versus 6.6%
  • RR 0.51
  • 95% CI 0.29-0.91
Death or substantial gross motor dysfunction:
  • 17.0 versus 22.7%
  • RR 0.75
  • 95% CI 0.59-0.96
BEAM 2241 24 to 31 6 g loading dose followed by 2 g/hour for maximum of 12 hours Death:
  • 9.5 versus 8.5%
  • RR 1.12
  • 95% CI 0.85-1.47
Moderate to severe cerebral palsy:
  • 1.9 versus 3.5%
  • RR 0.55
  • 95% CI 0.32-0.95*
Stillbirth or infant death by one year of corrected age or moderate or severe cerebral palsy at or beyond two years of corrected age:
  • 11.3 versus 11.7%
  • RR 0.97
  • 95% CI 0.77-1.23
 
PREMAG 573 <33 4 g loading dose, no maintenance dose     Cerebral palsy or death:
  • OR 0.65
  • 95% CI 0.42-1.03
Severe motor dysfunction or death:
  • OR 0.62
  • 95% CI 0.41-0.93
 
ACTOMgSO4: Australasian Collaborative Trial of Magnesium Sulphate; RR: relative risk; BEAM: Beneficial Effects of Antenatal Magnesium Sulfate; OR: odds ratio.
* When evaluated in terms of gestational age at randomization (<28 weeks versus ≥28 weeks), only infants of pregnancies randomized at <28 weeks had a significant reduction in moderate or severe cerebral palsy.
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