Evidence map›Paper›PMID 19622997›Full record

SynthesisObstetrics and gynecology2009

Effects of antenatal exposure to magnesium sulfate on neuroprotection and mortality in preterm infants: a meta-analysis.

Maged M Costantine, Steven J Weiner, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal–Fetal Medicine Units Network (MFMU)

Registry-linked trialOpen access · greenAbstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Obstetrics and gynecology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00014989 (Randomized Clinical Trial of the Beneficial Effects of Antenatal Magnesium Sulfate), which is not on this map. Cited by 56 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 6 pooled it
6.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00014989 phase3completednot on this map

Randomized Clinical Trial of the Beneficial Effects of Antenatal Magnesium Sulfate (BEAM)

TypeinterventionalSponsorThe George Washington University Biostatistics CenterRan1997 to 2007Enrolled2,136ConditionsCerebral Palsy, Intraventricular Hemorrhage, Periventricular Leukomalacia, Pulmonary EdemaArmsmagnesium sulfate
3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 6 syntheses or guidelines pooled it, 216 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Antenatal Magnesium Sulfate and adverse gastrointestinal outcomes in Preterm infants-a systematic review and meta-analysis.Journal of perinatology : official journal of the California Perinatal Association · 2023
    Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Review
  16. A dual-binding magnetic immunoassay to predict spontaneous preterm birth.Frontiers in bioengineering and biotechnology · 2023
    Article
  17. Article
  18. Article
  19. Review
  20. Management of clinical chorioamnionitis: an evidence-based approach.American journal of obstetrics and gynecology · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Maged M CostantineFrom the Department of Obstetrics and Gynecology at the University of Texas Medical Branch, Galveston, Texas; and the George Washington University Biostatistics Center, Washington, DC.
Steven J Weiner
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal–Fetal Medicine Units Network (MFMU)
The University of Texas Medical Branch at Galveston · US

Funding

Data Coord Ctr-NICHD Cooperative Multicenter Maternal Medicine Units Research NetU10HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI CLIFTON, REBECCA GERSNOVIEZ · 2009 to 2021
$174.2M
SARS-CoV-2 Vaccine Pregnancy RegistryU24HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI Rebecca Gersnoviez Clifton · 2021 to 2026
$39.2M
MATERNAL FETAL RESEARCH NETWORK: DATA COORDINATING CTRU01HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI THOM, ELIZABETH ANN · 1998 to 2008
$27.0M
Zosuquidar trihydrochloride for acute myeloid leukemia &refractory anemiaM01RR000080 · NCRR · UNIVERSITY HOSPITALS OF CLEVELAND · PI DEARBORN, DORR GELLATLY · 1985 to 2007
$22.2M
NICHD Maternal Fetal Medicine Units NetworkU10HD034116 · NICHD · UT SOUTHWESTERN MEDICAL CENTER · PI CASEY, BRIAN M · 1996 to 2015
$19.3M
NICHD Maternal Fetal Medicine Units NetworkU10HD034208 · NICHD · UNIVERSITY OF UTAH · PI VARNER, MICHAEL W. · 1996 to 2015
$16.6M
NICHD Maternal Fetal Medicine Units NetworkU10HD027869 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI TITA, ALAN THEVENET N. · 1991 to 2015
$12.8M
NICHD Maternal Fetal Medicine Units NetworkU10HD040485 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI WAPNER, RONALD · 2001 to 2015
$12.5M
NICHD Maternal Fetal Medicine Units NetworkU10HD040560 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI THORP, JOHN M · 2001 to 2015
$10.3M
Carolina Population CenterR24HD050924 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MORGAN, SAMUEL PHILIP · 2005 to 2014
$10.0M
NICHD Maternal Fetal Medicine Units NetworkU10HD040512 · NICHD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI GROBMAN, WILLIAM ADAM · 2001 to 2015
$8.7M
NICHD Maternal Fetal Medicine Units NetworkU10HD027917 · NICHD · WAYNE STATE UNIVERSITY · PI GONIK, BERNARD · 1991 to 2015
$8.2M
NCRR NIH HHS M01 RR000080NICHD NIH HHS HD21410NICHD NIH HHS HD21414NICHD NIH HHS HD27860NICHD NIH HHS HD27861NICHD NIH HHS HD27869NICHD NIH HHS HD27915NICHD NIH HHS HD27917NICHD NIH HHS HD34116NICHD NIH HHS HD34136NICHD NIH HHS HD34208NICHD NIH HHS HD34210NICHD NIH HHS HD36801NICHD NIH HHS HD40485NICHD NIH HHS HD40500NICHD NIH HHS HD40512NICHD NIH HHS HD40544NICHD NIH HHS HD40545NICHD NIH HHS HD40560NICHD NIH HHS HD53907NICHD NIH HHS R24 HD050924NICHD NIH HHS U01 HD019897NICHD NIH HHS U01 HD036801NICHD NIH HHS U10 HD021410NICHD NIH HHS U10 HD021414NICHD NIH HHS U10 HD027860NICHD NIH HHS U10 HD027861NICHD NIH HHS U10 HD027869NICHD NIH HHS U10 HD027905NICHD NIH HHS U10 HD027915NICHD NIH HHS U10 HD027917NICHD NIH HHS U10 HD034116NICHD NIH HHS U10 HD034122NICHD NIH HHS U10 HD034136NICHD NIH HHS U10 HD034208NICHD NIH HHS U10 HD034210NICHD NIH HHS U10 HD036801NICHD NIH HHS U10 HD040485NICHD NIH HHS U10 HD040500NICHD NIH HHS U10 HD040512NICHD NIH HHS U10 HD040544NICHD NIH HHS U10 HD040545NICHD NIH HHS U10 HD040560NICHD NIH HHS U10 HD053097NICHD NIH HHS U24 HD036801NICHD NIH HHS UG1 HD027869NICHD NIH HHS UG1 HD027915NICHD NIH HHS UG1 HD034116NICHD NIH HHS UG1 HD034208NICHD NIH HHS UG1 HD040485NICHD NIH HHS UG1 HD040500NICHD NIH HHS UG1 HD040512NICHD NIH HHS UG1 HD040544NICHD NIH HHS UG1 HD040545NICHD NIH HHS UG1 HD040560
6 · The paper itself

Abstract

objectiveTo review the evidence regarding neuroprotective effects of antenatal exposure to magnesium sulfate. DATA SOURCES: We conducted database searches of MEDLINE, the Cochrane Library and Controlled Trials Register, as well as the ClinicalTrials.gov and International Clinical Trials Register websites. Bibliographies of all relevant articles were reviewed. METHODS OF STUDY SELECTION: Randomized controlled trials comparing magnesium sulfate with placebo/other treatment in patients at risk of preterm delivery were evaluated for inclusion and methodological quality. The primary outcome was death or cerebral palsy by 18-24 months corrected age. Secondary outcomes were death, cerebral palsy, moderate-severe cerebral palsy, and death or moderate-severe cerebral palsy. Separate analyses were performed according to the gestational age (GA) at randomization (less than 32 to 34 weeks and less than 30 weeks) and for studies in which magnesium sulfate was used exclusively for fetal neuroprotection. TABULATION, INTEGRATION, AND

resultsFive randomized controlled trials were included (5,235 fetuses/infants). When analyzed by GA at randomization, in utero exposure to magnesium sulfate at less than 32-34 weeks did not reduce the rate of death or cerebral palsy (relative risk [RR] 0.92, 95% confidence interval [CI] 0.83-1.03). However, cerebral palsy (RR 0.70, 95% CI 0.55-0.89), moderate-severe cerebral palsy (RR 0.60, 95% CI 0.43-0.84), and death or moderate-severe cerebral palsy were significantly reduced, without an evident increase in the risk of death (RR 1.01, 95% CI 0.89-1.14). Similar results were obtained when the GA at randomization was less than 30 weeks. When only neuroprotection trials (four trials, 4,324 fetuses/infants) are analyzed, in utero exposure to magnesium sulfate additionally reduced the primary outcome of death or cerebral palsy. The number needed to treat to prevent one case of cerebral palsy among those who survive until age 18-24 months is 46 (95% CI 26-187) in infants exposed to magnesium sulfate in utero before 30 weeks, and 56 (95% CI 34-164) in infants exposed to magnesium sulfate in utero before 32 to 34 weeks.

conclusionFetal exposure to magnesium sulfate in women at risk of preterm delivery significantly reduces the risk of cerebral palsy without increasing the risk of death.

Indexed as

Infant, PrematureCerebral PalsyFemaleFetusGestational AgeHumansInfant, NewbornMagnesium SulfateMortalityPregnancyRandomized Controlled Trials as TopicTocolytic AgentsMagnesium SulfateTocolytic Agents

Identifiers

PMID19622997
PMCPMC2761069
OpenAlexW2061602313

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.