{ "release_id": "c7fb95f1d15a7d13", "id": "maternal:magnesium-sulfate-fetal-neuroprotection", "owner": "maternal", "kind": "intervention", "slug": "magnesium-sulfate-fetal-neuroprotection", "name": "Magnesium sulfate before very preterm birth to protect the baby's brain", "aliases": [], "atlases": [ "maternal" ], "summary_plain": "Magnesium sulfate given by drip to a woman who is likely to give birth very early, in the hope of protecting the baby's brain. In the BEAM trial it did not lower the combined risk of death or moderate or severe cerebral palsy. Moderate or severe cerebral palsy alone was less common with magnesium sulfate, in a secondary analysis. This is a separate use from magnesium sulfate for eclampsia, and results for one use do not apply to the other.", "summary_technical": "Medicine strategy: the mother receives the medicine and cerebral palsy is measured in the child, so the claim context is mixed and a separate maternal context holds the one maternal result. The BEAM abstract gives the regimen (a 6-g bolus then 2 g per hour, intravenously) and population (women at imminent risk of delivery between 24 and 31 weeks); no other trial of this use is recorded in this atlas. Kept apart from the eclampsia record and linked to the magnesium sulfate drug page.", "editorial_state": "draft", "last_substantive_edit": "2026-10-15", "last_evidence_check": "2026-10-15", "next_review_due": null, "identifiers": [], "navigation": { "maternal": { "life-stage": [ "pregnancy", "newborn", "infant-follow-up" ], "care-area": [ "preterm-and-sick-newborn" ] } }, "payload": { "subtype": "medicine", "mechanism": null, "components": null }, "content_digest": "5590575b48986a5488ec7cc04058e713644858a45d8f52d1af48d9c7df518911", "review": { "content_digest": "5590575b48986a5488ec7cc04058e713644858a45d8f52d1af48d9c7df518911", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "c7fb95f1d15a7d13", "id": "maternal:claim-beam-composite-and-cerebral-palsy", "owner": "maternal", "subject_entity_id": "maternal:magnesium-sulfate-fetal-neuroprotection", "category": "effect", "statement": "In BEAM, 2241 women at imminent risk of delivery between 24 and 31 weeks of gestation were randomly assigned, in a placebo-controlled, double-blind trial, to intravenous magnesium sulfate (a 6-g bolus then 2 g per hour) or matching placebo. The primary outcome, a composite of stillbirth or infant death by 1 year of corrected age or moderate or severe cerebral palsy at or beyond 2 years of corrected age, was not significantly different: 11.3% with magnesium sulfate and 11.7% with placebo (relative risk 0.97; 95% CI 0.77 to 1.23). In a prespecified secondary analysis, moderate or severe cerebral palsy occurred significantly less often with magnesium sulfate (1.9% against 3.5%; relative risk 0.55; 95% CI 0.32 to 0.95). The risk of death did not differ significantly (9.5% against 8.5%; relative risk 1.12; 95% CI 0.85 to 1.47). Follow-up was achieved for 95.6% of the children. The authors conclude that fetal exposure did not reduce the combined risk of moderate or severe cerebral palsy or death, although the rate of cerebral palsy was reduced among survivors.", "context": { "id": "maternal:ctx-beam-women-and-offspring-24-31w", "label": "Women at imminent risk of delivery at 24 to 31 weeks, and their fetuses and children (BEAM trial)", "recipient": "mixed", "population": "2241 women at imminent risk of delivery between 24 and 31 weeks of gestation underwent randomisation; follow-up was achieved for 95.6% of the children. The registry's criteria add preterm labour with membrane rupture or planned delivery within 24 hours, and exclude women with hypertension or pre-eclampsia, among others. The medicine was given to the women; the primary outcome counts stillbirth and infant death together with moderate or severe cerebral palsy in the children, so the measured group is fetuses and children.", "care_setting": "A multicentre, placebo-controlled, double-blind trial; the abstract names no wards (the registry lists United States sites)", "geography": "United States (ClinicalTrials.gov locations)", "life_stage_note": "Pregnancy at 24 to 31 weeks with imminent delivery risk; children followed to 1 year and to 2 years or more of corrected age", "life_stage_terms": { "maternal": [ "pregnancy", "newborn", "infant-follow-up" ] }, "gestational_age_min_days": 168, "gestational_age_max_days": 223, "gestational_age_basis": "at_enrolment", "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Stillbirth or infant death by 1 year of corrected age, and moderate or severe cerebral palsy at or beyond 2 years of corrected age.", "eligibility": { "inclusion": [ "Women at imminent risk for delivery between 24 and 31 weeks of gestation (abstract)", "Pregnant with a diagnosis of preterm labour; membrane rupture or delivery definitely planned within 24 hours; gestational age above 24.0 and below 31.6 weeks with a viable fetus (registry)" ], "exclusion": [ "Hypertension or pre-eclampsia (registry)", "Prior intravenous magnesium sulfate within 12 hours of screening", "Delivery expected in under 2 hours; cervical dilation over 8 cm", "More than 2 fetuses; known major fetal anomalies", "Maternal medical complications contraindicating magnesium sulfate treatment", "Participation in any intervention study that influences infant neurological outcome; previous participation in this trial" ] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "Only the abstract was read. The trial's own primary outcome showed no benefit; the cerebral palsy result is a prespecified secondary analysis and the abstract gives no denominator for the cerebral palsy percentages. The composite counts stillbirths and infant deaths as well as cerebral palsy, which is why the context is mixed. The registry gives 2136 participants and the paper 2241 women randomised; the two are not reconciled here. This is magnesium sulfate given before early preterm birth for the baby's brain; it is a different use from eclampsia prevention and its evidence does not carry over.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, RESULTS sentences 3 to 6 and CONCLUSIONS sentence 1", "applicability_note": "Primary composite, cerebral palsy, death and the authors' conclusion.", "snapshot": { "id": "maternal:pubmed-18753646-2026-10-14", "retrieved_at": "2026-10-14T18:18:28Z", "content_hash": "62ea8b7a65c13b5cc1b05f46b9c64c7a87f1d1be329c82c208ea044f0258b94d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:pubmed-10-1056-nejmoa0801187", "source_type": "publication", "title": "A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy", "canonical_url": "https://doi.org/10.1056/NEJMoa0801187", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa0801187", "normalized_value": "10.1056/nejmoa0801187", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "18753646", "normalized_value": "18753646", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC2803083", "normalized_value": "PMC2803083", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2008-08-28", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). 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The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } } ], "review": { "content_digest": "6e26d382a6a3c2f81f415260efa248d3980b3d88a525dc035ab3d161e3f9157e", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/maternal--claim-beam-composite-and-cerebral-palsy.json" }, { "release_id": "c7fb95f1d15a7d13", "id": "maternal:claim-beam-maternal-safety", "owner": "maternal", "subject_entity_id": "maternal:magnesium-sulfate-fetal-neuroprotection", "category": "safety", "statement": "In BEAM, the abstract reports that no woman had a life-threatening event.", "context": { "id": "maternal:ctx-beam-women-24-31w", "label": "Women at imminent risk of delivery at 24 to 31 weeks who received magnesium sulfate or placebo (BEAM trial)", "recipient": "maternal", "population": "The 2241 women randomised in BEAM, at imminent risk for delivery between 24 and 31 weeks of gestation. This context is for outcomes counted in the women; the abstract reports one: whether any woman had a life-threatening event.", "care_setting": "A multicentre, placebo-controlled, double-blind trial; the abstract names no wards", "geography": "United States (ClinicalTrials.gov locations)", "life_stage_note": "Pregnancy at 24 to 31 weeks with imminent delivery risk", "life_stage_terms": { "maternal": [ "pregnancy" ] }, "gestational_age_min_days": 168, "gestational_age_max_days": 223, "gestational_age_basis": "at_enrolment", "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Maternal events during the trial; the abstract gives no other maternal outcomes.", "eligibility": { "inclusion": [ "Women at imminent risk for delivery between 24 and 31 weeks of gestation (abstract)", "Pregnant with a diagnosis of preterm labour; membrane rupture or delivery definitely planned within 24 hours; gestational age above 24.0 and below 31.6 weeks with a viable fetus (registry)" ], "exclusion": [ "Hypertension or pre-eclampsia (registry)", "Prior intravenous magnesium sulfate within 12 hours of screening", "Delivery expected in under 2 hours; cervical dilation over 8 cm", "More than 2 fetuses; known major fetal anomalies", "Maternal medical complications contraindicating magnesium sulfate treatment", "Participation in any intervention study that influences infant neurological outcome; previous participation in this trial" ] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "Only the abstract was read, and it reports this one maternal result with no number of women per group and no other maternal outcome (the registry lists maternal secondary outcomes, but their results were not read). It does not say that no woman had any side effect.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, RESULTS sentence 7", "applicability_note": "Maternal life-threatening events.", "snapshot": { "id": "maternal:pubmed-18753646-2026-10-14", "retrieved_at": "2026-10-14T18:18:28Z", "content_hash": "62ea8b7a65c13b5cc1b05f46b9c64c7a87f1d1be329c82c208ea044f0258b94d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:pubmed-10-1056-nejmoa0801187", "source_type": "publication", "title": "A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy", "canonical_url": "https://doi.org/10.1056/NEJMoa0801187", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa0801187", "normalized_value": "10.1056/nejmoa0801187", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "18753646", "normalized_value": "18753646", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC2803083", "normalized_value": "PMC2803083", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2008-08-28", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. 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