The neuroprotective effects of magnesium sulfate in utero exposure

Abstract

Prematurity affects 1 in 10 births and is associated with different degrees of disability and leads to a higher risk of neurological impairment and cerebral palsy (CP). Because its prevalence increase, but with a decrease in mortality rate, there is a burden of survivors that develop sequelae, a problem for the healthcare systems worldwide and for the patient’s social integration. Magnesium sulfate is a useful tool to limit the development of such complications. The risk factors for preterm brain injury act antenatally, intrapartum and postpartum. Even though there are several trials that tried to assess it benefits, magnesium sulfate is on the D list of U.S. Food and Drug Administration for pregnancy and several Societies of Obstetrics and Gynecology tried to implement national guidelines for its safe use. In conclusion it should be used with caution, within 24 hours before birth and under medical surveillance and to administer it only in pregnancies that are at high risk of premature childbirth. If there is a medical emergency involving the mother or the fetus, delivery should not be postponed in order to administer de magnesium sulfate.