Magnesium sulphate at 30 to 34 weeks’ gestational age: neuroprotection trial (MAGENTA) - study protocol

Crowther, Caroline A; Middleton, Philippa; Wilkinson, Dominic; Ashwood, Pat; Haslam, Ross

doi:10.1186/1471-2393-13-91

Cited by 41 publications

(47 citation statements)

References 48 publications

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“…The Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynaecologists use <32 weeks, whereas the Royal College of Obstetricians and Gynaecologists in the UK recommend <30 weeks’ gestation, as do the Australian and New Zealand guidelines . Further information on use at higher gestations will be available when the Magenta Trial is completed in 2020.…”

Section: Discussionmentioning

confidence: 99%

Survey on use of antenatal magnesium sulphate for fetal neuroprotection prior to preterm birth in Australia and New Zealand – Ongoing barriers and enablers

Gatman

May

Crowther

2019

Aust NZ J Obst Gynaeco

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Background Clinical practice guidelines recommend the use of antenatal magnesium sulphate for fetal neuroprotection before preterm birth at <30 weeks’ gestation. Aims This survey assessed the use of antenatal magnesium sulphate for fetal neuroprotection to determine if use has changed since the previous survey in 2012, and to evaluate enablers and barriers to use. Materials and Methods A questionnaire was sent to clinical leaders at 29 hospitals with a neonatal intensive care unit in Australia and New Zealand asking at what gestational ages magnesium sulphate was given, if use was audited and any enablers and barriers to use. Results Responses were received for 24 (83%) hospitals. The use of magnesium sulphate for fetal neuroprotection was reported as 89% (IQR 80–90%), an increase from 80% (IQR 53–90%) from the earlier survey. The majority of health professionals were reported as using magnesium sulphate at <30 weeks’ gestation. The top enablers for use of magnesium sulphate were availability of pamphlets, posters, case record stickers and PowerPoint presentations. The main reasons as to why eligible women did not receive magnesium sulphate were imminent birth, the hospital being short staffed and the patient declined. The use of antenatal magnesium sulphate has been or is being audited in 11 (46%) of the hospitals. Conclusions Clinical leaders at institutions in Australia and New Zealand report that uptake in the use of magnesium sulphate for fetal neuroprotection has continued to increase since the earlier, bi‐national survey in 2012. Barriers to the use of magnesium sulphate identified have institutional and consumer implications.

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Section: Discussionmentioning

confidence: 99%

Survey on use of antenatal magnesium sulphate for fetal neuroprotection prior to preterm birth in Australia and New Zealand – Ongoing barriers and enablers

Gatman

May

Crowther

2019

Aust NZ J Obst Gynaeco

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“…There remains uncertainty as to whether these benefits also apply at higher gestational ages. The MAGENTA trial will assess the benefit of giving MgSO 4 between 30 and 34 weeks of gestation in a randomised controlled trial (MgSO 4 versus placebo), with a primary outcome examining the rate of death and CP at 2 years of age. Once reported, this will enable further evidence‐based recommendations for the use of MgSO 4 in preterm deliveries occurring between 30 and 34 weeks.…”

Section: Key Studies On Mgso4 Use For Neuroprotection In Preterm Delimentioning

confidence: 99%

Use of magnesium sulfate in preterm deliveries for neuroprotection of the neonate

Usman

Foo

Tay

et al. 2017

The Obstetric & Gynaecologis

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Key content The prevalence of preterm birth is increasing and owing to advances in neonatal care, more infants are surviving. However, in parallel with this, the incidence of cerebral palsy (CP) is also rising. Magnesium sulfate (MgSO4) is currently recommended for use in women who are at risk of giving birth at less than 30–32 weeks of gestation for neuroprotection of their infants. The exact mechanism of action remains unclear. Meta‐analyses report encouraging results that are consistent with a modest but tangible benefit for the use of MgSO4, and suggest a number needed to treat (NNT) to prevent one in 46 cases of CP in infants born preterm before 30 weeks of gestation and one in 63 cases of CP in infants born preterm before 34 weeks of gestation. Learning objectives To gain an understanding of the risk of neurodisability in infants delivered preterm. To become familiar with the main studies assessing the use of MgSO4 for neuroprotection in preterm deliveries. To become aware of the relevant international guidelines. Ethical issues Concerns have been raised regarding the higher number of perinatal deaths reported with the use of MgSO4 in the MagNET study. This was not substantiated in the Cochrane review. Given that MgSO4 is a safe, readily available and inexpensive drug, even if there were only to be modest benefits from its use, the risk–benefit ratio is in favour of its use.

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“…Si bien en Australia la neuroprotección se indica hasta la semana 30, en la actualidad, se encuentra en curso el estudio aleatorizado multicéntrico MAGENTA -Magnesium sulphate at 30 to 34 weeks' gestational Age: Neuroprotection Trial-encabezado por la Universidad de Adelaida, que comparará la administración de sulfato de magnesio entre las 30 y las 34 semanas contra placebo. 19 La hipótesis primaria es que el sulfato de magnesio administrado a las pacientes en riesgo de parto pretérmino inminente en esa edad gestacional reduce las tasas de muerte o parálisis cerebral a los dos años de edad corregida.…”

Section: ¿Hasta Las 34 Semanas?unclassified

Actualización sobre el uso de sulfato de magnesio como neuroprotector en el parto prematuro

2015

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The administration of magnesium sulphate to mothers at risk for preterm birth for fetal neuroprotection has demonstrated to reduce the risk of cerebral palsy and gross motor dysfunction by 30-40%. Although there is controversy regarding the regimen of administration of magnesium sulphate, the gestational age limit, the extent of its potential benefit or even if it provides any benefit, current evidence is enough to support the use of magnesium sulphate in women at imminent risk for preterm delivery before 32 weeks of gestation. The objective of this study is to describe available evidence and current recommendations regarding neuroprotection with magnesium sulphate.

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Magnesium sulphate at 30 to 34 weeks’ gestational age: neuroprotection trial (MAGENTA) - study protocol

Cited by 41 publications

References 48 publications

Survey on use of antenatal magnesium sulphate for fetal neuroprotection prior to preterm birth in Australia and New Zealand – Ongoing barriers and enablers

Survey on use of antenatal magnesium sulphate for fetal neuroprotection prior to preterm birth in Australia and New Zealand – Ongoing barriers and enablers

Use of magnesium sulfate in preterm deliveries for neuroprotection of the neonate

Actualización sobre el uso de sulfato de magnesio como neuroprotector en el parto prematuro

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