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. 2012 Feb 15;2012(2):CD009302.
doi: 10.1002/14651858.CD009302.pub2.

Different magnesium sulphate regimens for neuroprotection of the fetus for women at risk of preterm birth

Emily Bain  1 , Philippa Middleton, Caroline A Crowther
Affiliations

Different magnesium sulphate regimens for neuroprotection of the fetus for women at risk of preterm birth

Emily Bain et al. Cochrane Database Syst Rev. .

Abstract

Background: The effectiveness of antenatal magnesium sulphate for neuroprotection of the fetus, infant, and child prior to very preterm birth, when given to women considered at risk of preterm birth, has been established. There is currently no consensus as to the regimen to use in terms of the dose, duration, the use of repeat dosing and timing.

Objectives: To assess the comparative effectiveness and adverse effects of different magnesium sulphate regimens for neuroprotection of the fetus in women considered at risk of preterm birth.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2011).

Selection criteria: Randomised trials comparing different magnesium sulphate regimens when used for neuroprotection of the fetus in women considered at risk of preterm birth. We planned to include cluster trials. We planned to exclude quasi-randomised trials and those with a crossover design. We planned to include trials published as full-text papers, along with those published in abstract form only.

Data collection and analysis: We planned that at least two review authors would assess trial eligibility.

Main results: No eligible completed trials were identified.

Authors' conclusions: Although strong evidence supports the use of antenatal magnesium sulphate for neuroprotection of the fetus prior to very preterm birth, no trials comparing different treatment regimens have been completed. Research should be directed towards comparisons of different dosages and other variations in regimens, evaluating both maternal and infant outcomes.

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Conflict of interest statement

The three review authors (Emily Bain, Philippa Middleton, and Caroline Crowther) are investigators in the IRIS trial (A randomised clinical trial of different infusion rates of magnesium sulphate given prenatally to women), which may be included in a future update of the review (Crowther 2011b ‐ see Characteristics of ongoing studies). Trial eligibility, data extraction and the risk of bias for this trial will therefore be carried out by two individuals independent to the trial. Caroline Crowther was the principal investigator for the Australasian Collaborative Trial of Magnesium Sulphate (ACTOMgSO4 ‐ Crowther 2003).

Two review authors (Philippa Middleton and Caroline Crowther) were members of the Guideline Development Panel, for the Australian National Health and Medical Research Council approved Antenatal Magnesium Sulphate Prior to Preterm Birth for Neuroprotection of the Fetus, Infant and Child National Clinical Practice Guidelines (NHMRC 2010).

Update of

References

References to ongoing studies

Crowther 2011b {unpublished data only}
    1. Crowther C. A randomised clinical trial of different infusion rates of magnesium sulphate given prenatally to women for the prevention of side effects. Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) (accessed 19 February 2008).

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