Drug cuts risk of pre-term cerebral palsy in half

Results of a 10-year study published in the August 28 issue of the New England Journal of Medicine found that magnesium sulfate administered to women delivering before 32 weeks of gestation reduced the risk of cerebral palsy by 50 percent. The Beneficial Effects of Antenatal Magnesium Sulfate (BEAM) trial was conducted in 18 centers in the U.S., including Northwestern Memorial, and is the first prenatal intervention ever found to reduce the instance of cerebral palsy related to premature birth.

Magnesium sulfate is traditionally used in obstetrics to stop premature labor and prevent seizures in women with hypertension. The BEAM trial studied the link between magnesium sulfate and cerebral palsy by identifying 2,240 women who were likely to give birth more than two months premature. Half of the women intravenously received magnesium sulfate while the other half received a placebo. Children born to the women in the study were examined at two-years-old, and results found that the children in the magnesium group were 50 percent less likely to develop cerebral palsy compared to children in the placebo group.

“This is a substantial breakthrough in maternal fetal medicine that could positively impact the health of thousands of babies,” said Alan Peaceman, MD, chair of the Division of Maternal Fetal Medicine at Northwestern Memorial Hospital, professor of Obstetrics and Gynecology at the Northwestern University Feinberg School of Medicine, and an investigator in the study. “After 10 years of studying the effects of magnesium sulfate, it has proven to be a successful method of reducing the outcome of cerebral palsy in premature births.”

Cerebral palsy is a group of neurological disorders that appears in infancy or early childhood and permanently affects body movement and muscle coordination. In the U.S., two to three children in 1,000 are affected with cerebral palsy, and about 800,000 children and adults of all ages have the disorder, which is caused by damage in parts of the brain that control muscle movements.

The most common form of cerebral palsy is congenital, resulting from intra-uterine brain injury and accounting for approximately 70 percent of cases. Although there is no direct cause of the disorder, risk factors including premature birth and low birth weight are directly correlated to instances of cerebral palsy.

“Based on results of the study, in the future it is possible that women at risk of prematurely giving birth could proactively receive magnesium sulfate to reduce their child’s chances of developing cerebral palsy,” adds Dr. Peaceman. “With additional research, it is possible that in the next few years this will be a standard of care.”

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August 31, 2008