Major Research Findings

A meta-analysis has suggested that magnesium sulfate may have effects on neuroprotection and mortality in preterm infants. 2 This analysis found evidence that magnesium sulfate could have neuroprotective effects.

Magnesium sulfate has been traditionally used as a standard treatment for severe preeclampsia and eclampsia to prevent seizures, but its efficacy has always been in doubt, and its induced side effects also make it controversial for use. 1 One study found no significant difference in the incidence of eclampsia between the magnesium sulfate group and the non-magnesium sulfate group. However, the magnesium sulfate group had a higher rate of cesarean delivery, with most cases significantly attributed to fetal distress (p < 0.05). Furthermore, the magnesium sulfate group had significantly more babies with poor Apgar scores than the non-magnesium sulfate group (p = 0.019). During the treatment period for those with a gestational age of less than 34 weeks, there were two patients with abruptio placentae in the magnesium sulfate group, and the treatment periods were noted to be longer in the non-magnesium sulfate group than in the magnesium sulfate group. Based on the results of monitoring serum magnesium levels in the magnesium sulfate group, when therapeutic levels were achieved, magnesium sulfate induced significant discomfort, which may have led to a deterioration of the patients' condition. According to this study, magnesium sulfate's minimal efficacy and its adverse side effects also make magnesium sulfate a poor choice in the management of preeclampsia. Therefore, due to our poor understanding of the etiology of preeclampsia, appropriate management should be undertaken without magnesium sulfate. Improvement of the patient's pathophysiological condition or termination of pregnancy as early as possible is recommended.

A study examined the effects of magnesium sulfate on non-neurologic neonatal outcomes in relation to cord blood magnesium levels. 3 This study suggests that magnesium sulfate may have an effect on these outcomes.

Benefits and Risks

Benefit Summary

Magnesium sulfate may help to protect preterm infants from neurological damage. 2

Risk Summary

Magnesium sulfate may cause side effects, such as an increase in cesarean delivery rates and a decrease in Apgar scores in newborns. 1

Comparison Between Studies

Commonalities

All of these studies explored the potential benefits and risks of magnesium sulfate. However, the studies varied in their purpose and design.

Differences

The meta-analysis reviewed previous studies on the neuroprotective effects of magnesium sulfate. 2 The study on the treatment of severe preeclampsia assessed the efficacy and side effects of magnesium sulfate. 1 The study examining the relationship between cord blood magnesium levels at birth and neonatal outcomes analyzed the potential influence of magnesium sulfate on neonatal outcomes. 3

Consistency and Contradictions in Results

The results of these studies suggest that magnesium sulfate may have both potential benefits and risks. It may help protect preterm infants from neurological damage, but it may also cause side effects such as an increase in cesarean delivery rates and a decrease in Apgar scores in newborns.

Considerations for Real-Life Application

The use of magnesium sulfate should be carefully considered, taking into account its potential benefits and risks. Physicians should consider the specific circumstances of each patient and determine if the potential benefits of magnesium sulfate outweigh the risks.

Limitations of Current Research

There are some limitations to these studies. For example, the meta-analysis was based on a review of previous studies and did not itself provide new data. 2 The study on the treatment of severe preeclampsia was small, and it is unclear whether the results can be generalized. 1 The study examining the relationship between cord blood magnesium levels at birth and neonatal outcomes requires further research to establish the association. 3

Future Research Directions

Further research is needed to investigate the effects of magnesium sulfate in more detail. Future studies should investigate the optimal dosage of magnesium sulfate, ways to minimize the risk of side effects, and identifying patients who are likely to benefit from magnesium sulfate.

Conclusion

Magnesium sulfate has been shown to have both potential benefits and risks. Its use should be decided on a case-by-case basis, carefully considering the patient's individual circumstances. Further research is needed to gain a deeper understanding of the effects of magnesium sulfate.