Evidence map›Paper›PMID 38468452›Full record

SynthesisDevelopmental medicine and child neurology2024

Neonatal magnesium sulphate for neuroprotection: A systematic review and meta-analysis.

Emily Shepherd, Tasneem Karim, Sarah McIntyre, Shona Goldsmith, Amy Keir, Nadia Badawi, Rod W Hunt, Robert Galinsky

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Developmental medicine and child neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. 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

8 authors.

Emily ShepherdWomen and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.ORCID 0009-0005-2608-2061
Tasneem KarimCerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Sarah McIntyreCerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-0234-1541
Shona GoldsmithCerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-3903-6142
Amy KeirWomen and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Nadia BadawiCerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Rod W HuntCerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-2446-1739
Robert GalinskyThe Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.

Funding

National Health and Medical Research Council, Australia ID 2007800
6 · The paper itself

Abstract

aimTo review the evidence of the effects of neonatal magnesium sulphate for neuroprotection in perinatal asphyxia and hypoxic-ischaemic encephalopathy (HIE).

methodThis was a systematic review of randomized controlled trials (RCTs) (with meta-analysis) and non-RCTs assessing magnesium sulphate for treating perinatal asphyxia and HIE at 35 weeks or more gestation (primary outcomes: neonatal death and death or long-term major neurodevelopmental disability).

resultsTwenty-five RCTs (2099 infants) and four non-RCTs (871 infants) were included, 23 in low- and middle-income countries (LMICs). In RCTs, reductions in neonatal death with magnesium sulphate versus placebo or no treatment (risk ratio [RR] = 0.68; 95% confidence interval [CI] = 0.53-0.86; 13 RCTs), and magnesium sulphate with melatonin versus melatonin alone (RR = 0.74; 95% CI = 0.58-0.95; one RCT) were observed. No difference in neonatal death was seen for magnesium sulphate with therapeutic hypothermia versus therapeutic hypothermia alone (RR = 0.66, 95% CI = 0.34-1.26; three RCTs), or magnesium sulphate versus phenobarbital (RR = 3.00; 95% CI = 0.86-10.46; one RCT). No reduction in death or long-term neurodevelopmental disability (RR = 0.52; 95% CI = 0.14-1.89; one RCT) but reductions in several short-term adverse outcomes were observed with magnesium sulphate. Evidence was low- to very-low certainty because of risk of bias and imprecision.

interpretationGiven the uncertainty of the current evidence, further robust neonatal magnesium sulphate research is justified. This may include high-quality studies to determine stand-alone effects in LMICs and effects with and after therapeutic hypothermia in high-income countries.

Indexed as

Asphyxia NeonatorumHypoxia-Ischemia, BrainMagnesium SulfateNeuroprotective AgentsHumansHypothermia, InducedInfant, NewbornRandomized Controlled Trials as TopicMagnesium SulfateNeuroprotective Agents

Identifiers

PMID38468452
PMCPMC11579813

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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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 Socratic graph.