Magnesium sulfate before very preterm birth linked to more babies surviving without cerebral palsy

Researchers from the South Australian Health and Medical Research Institute (SAHMRI) and collaborating institutions analyzed outcomes for children born extremely preterm or with very low birth weight across Australia and New Zealand. The study, published in the American Journal of Obstetrics & Gynecology, compared children who received antenatal magnesium sulfate before birth with those who did not.

The analysis showed that infants exposed to magnesium sulfate were more likely to survive to 2–3 years of age without a diagnosis of cerebral palsy or moderate-to-severe functional impairment. Cerebral palsy is the most common physical disability in childhood and occurs more frequently in babies born very preterm, affecting movement, posture and coordination throughout life.

Lead author Dr. Emily Shepherd said the findings provide reassurance that the neuroprotective benefits observed in earlier clinical trials are being realized in routine clinical practice. She described magnesium sulfate as a simple, low-cost treatment that can have a lifelong impact for babies born very early.

The study supports the continued use and broader implementation of clinical practice guidelines that recommend magnesium sulfate infusion for women at risk of very preterm birth. The researchers emphasized that seeing improved survival without cerebral palsy at a population level demonstrates how evidence-based care can change outcomes for children and families.

The research was conducted by Dr. Shepherd, Professor Alice Rumbold, Associate Professor Lisa Yelland and collaborators from across Australia and New Zealand. The study used observational data from routine health-care settings rather than a controlled trial environment.

Because the study is observational, it cannot prove causation, and the authors note that residual confounding may influence the results. The findings add to a body of evidence from randomized trials that have previously demonstrated magnesium sulfate's neuroprotective effects for the preterm fetal brain.