The use of magnesium sulfate as a possible treatment for cerebral palsy is an appealing idea to many doctors: The compound is already used regularly to halt contractions when women go into labor very early. Moreover, the drug is found in virtually every hospital's delivery room and costs only pennies for one dose.
Based on this research, Dr. Sandra McCalla, director of the Division of Obstetrics at Maimonides Medical Center in Brooklyn, N.Y., told John McKenzie of "World News With Charles Gibson" that she believes "this is one of the most promising breakthroughs in decades to help pregnant women at imminent [risk] for premature delivery."
But despite past success with this treatment in previous studies, many experts remain hopeful but cautious about which patients might benefit from this treatment.
"The results call for more study as to mechanism, potential toxicities and identification of specific preterm infants for whom this approach may be beneficial," said Dr. H. William Taeusch, professor of pediatrics at the University of California at San Francisco. "There is no direct evidence of the mechanism of the effect. Nor are potential side effects of [magnesium sulfate] in the newborn fully explored in this study."
Many experts also warned that although this study touts magnesium sulfate as a safe treatment for both mother and baby, the side effects of the treatment have not been studied extensively enough to make such a conclusion.
"To say that this is a safe practice is a bit of an overstatement," said Dr. Steven Donn, professor of pediatrics and director of the Division of Neonatal-Perinatal Medicine at the University of Michigan Health System. "High serum magnesium levels in the newborn also depress respiratory drive, sometimes requiring the use of mechanical ventilation where it might not have been needed, and it can interfere with gastrointestinal function and delay feeding."
Moreover, many experts agreed that the number of patients needed to be treated with magnesium sulfate in order to prevent one case of CP is much too high for this to be considered as a new standard of care for women at risk for premature birth.
"Remember, this study was conducted in very subspecialized centers, with abundant skilled providers for both mothers and babies," Donn said. "What happens when it is moved to community hospitals may have a totally different result."
"What is likely to happen is that it will be used more liberally and pragmatically, increasing the denominator of patients and probably diluting the effect," he said.
Overall, experts agree that the prudent way to view these findings is with cautious hope.
"Neonatology has had enough misadventures with drugs that initially 'looked good,' only to find out later that there were significant side effects and complications, sometimes life-threatening, that we need to await longer term outcomes before embracing a new therapy as a standard practice," Donn added.