Epsom salts protect premature babies

Main Category: Public Health
Article Date: 01 Dec 2003 - 0:00 PDT

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CHICAGO (USA) - Preliminary data suggests that Epsom salts given intravenously to women about to deliver extremely premature babies help reduce brain damage and death among the infants, Australian researchers reported this week.

Children born before 30 weeks' gestation - about two months early - run a higher risk of death and brain problems, including cerebral palsy, said the report published in the Journal Of The American Medical Association.

Caroline Crowther, a physician at the University of Adelaide, and colleagues said they tested the use of Epsom salts - magnesium sulfate - at 16 hospitals in Australia and New Zealand involving 1,062 women about to deliver very premature babies.

Children of women given the salts had a 17 per cent reduced risk of death and cerebral palsy, the study concluded.

The apparent protective mechanism involved is not clear, the study said, but it appears the salts may help prevent bleeding in the premature infant brain, a problem that can cause cerebral palsy.

The researchers said further urgent studies are needed as 'widespread use of prenatal magnesium sulfate as a neuroprotective agent cannot be recommended solely on the basis of the current study.'

In an accompanying editorial, Jon Tyson and Larry Gilstrap, physicians at the University of Texas Medical School, called the findings encouraging.

Another study found that giving nitric oxide to premature babies with breathing trouble can reduce their risk of death, lingering lung problems and brain damage - a finding that could help make the gas standard treatment in a few years.

In a study of 207 babies, doctors at the University of Chicago found major benefits from giving a low dose of nitric oxide gas to premature newborns with respiratory distress, or inability to breathe in enough air.

The one-week treatment cut their risk of death or lung problems to 49 per cent, compared with 64 per cent in preemies getting just oxygen from a breathing machine. The preemies breathing nitric oxide were 47 per cent less likely to develop severe bleeding in the brain and damage to brain tissue.

Those babies also spent less time on a breathing machine and went home sooner.

Still, lead researcher Dr. Michael Schreiber, a neonatologist and associate professor of pediatrics at University of Chicago, said nitric oxide should not be widely used until studies underway now confirm his results.

'We don't know what the optimal dose is. We don't know what the optimal length of treatment is,' Schreiber said.

The study was reported in the New England Journal Of Medicine.

'This is not a baby step. This is a major step in the advancement of care for premature infants,' said Dr. Jessie Roberts, associate professor at Harvard Medical School and a neonatologist at Massachusetts General Hospital.

Nitric oxide - not to be confused with the 'laughing gas' nitrous oxide - is produced by many cells in the body. Among other things, it reduces inflammation and dilates blood vessels in the lungs, getting more oxygen into circulation.