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April 2, 1997

Prenatal Magnesium Sulfate Exposure and Risk of Cerebral Palsy-Reply

Author Affiliations

Centers for Disease Control and Prevention Atlanta, Ga

JAMA. 1997;277(13):1033-1034. doi:10.1001/jama.1997.03540370023016

In Reply.  —Dr Allred and colleagues propose that magnesium sulfate was not a first-line tocolytic in the mid 1980s, but was given almost exclusively for preeclampsia, and that preeclampsia independently contributed to the reduced risk for cerebral palsy in very low-birth-weight infants. For this to be possible, they argue that magnesium sulfate was a marker for both documented and undocumented preeclampsia, since only 45% of the women treated with the drug in our study had documented preeclampsia. Following the example of Allred et al, we examined the concordance among prenatal magnesium sulfate treatment, documented preeclampsia, eclampsia, or hypertension in a woman's medical record, and the same woman's report on interview (yes/no) that she had a hypertensive disorder of pregnancy (toxemia, preeclampsia, hypertension, or seizures caused by pregnancy). Of the 405 (49%) of 833 Atlanta women in our study cohort who were interviewed, 88 (22%) were treated with magnesium sulfate. Forty-five (51%) of