A new Cochrane meta-analysis has reaffirmed the significant role of magnesium sulfate in reducing the risk of cerebral palsy (CP) and death in preterm infants. This comprehensive review, which analyzed six randomized controlled trials involving nearly 6,000 pregnant participants, provides compelling evidence for the use of this inexpensive intervention in preventing lifelong disability.
The review revealed that magnesium sulfate administration to pregnant women at risk of premature delivery:
*Significantly reduced the risk of CP in children up to 2 years of corrected age (relative risk of 0.71)
*Decreased the combined risk of death or CP (relative risk of 0.87)
*Moderately reduced the risk of severe neonatal intraventricular (brain) hemorrhage
These findings underscore the importance of magnesium sulfate as a neuroprotectant for preterm babies, a recommendation that has been supported by the World Health Organization since 2015.
While not directly related to the CP study, it’s worth noting that magnesium also plays a crucial role in migraine prevention and treatment. Magnesium deficiency, which is present in almost half of migraine sufferers, leads to increased migraine frequency and severity.
Many neurologists recommend magnesium supplements as part of a comprehensive migraine prevention strategy. We sometimes check RBC magnesium levels (the more accurate test than serum levels) before recommending supplementation. Chelated forms of magnesium, such as magnesium glycinate, are better absorbed than magnesium oxide, which is the type most commonly sold in stores. Oral magnesium can help the majority of people who are deficient. About 10%, however, do not absorb oral magnesium. We have these patients come into our clinic for monthly infusions.
Both oral and intravenous magnesium are safe in pregnancy.
However, I have heard some doctors and patients express concern about the harmful effects of magnesium in pregnancy. Indeed, mothers who receive very large amounts of intravenous magnesium (thousands of grams) over a period of more than 5-7 days may deliver babies suffering from osteoporosis, bone fractures, and other problems.
The amount of intravenous magnesium we give our migraine patients is one gram. So, pregnant women can safely take oral magnesium and receive regular intravenous infusions of 1-2 grams of magnesium.
