We congratulate Idama and Lindow on their thorough review of the clinical pharmacology of magnesium sulphate (Vol 105, March 1998)1. We would however like to draw attention to possible adverse paediatric consequences of antenatal magnesium therapy. The MAGnet trial2 examined the effects of antenatal magnesium exposure, both for tocolysis and also as a single dose in advanced pre-term labour, on subsequent cerebral palsy rates. Unfortunately, the trial had to be stopped at the interim safety monitoring stage because of an excess of paediatric deaths in the groups exposed to antenatal magnesium sulphate (risk difference 10.7%, 95% CI 2.9%-185%, Fisher's exact test, P= 0.02). Magnesium sulphate used in very pre-term labour may be associated with excess paediatric mortality.


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