Cerebral palsy and experimental hypoxia-induced perinatal brain injury: is magnesium protective?

Recent retrospective, observational studies describe an association between maternal administration of magnesium and a reduction in cerebral palsy in low birthweight infants. Cerebral palsy is thought to result mainly from hypoxia-induced brain injury, and its incidence is increasing due to recent advances in obstetric and newborn intensive care. The findings of the observational studies raise the promising possibility that magnesium treatment may protect the immature brain from hypoxia-induced injury and thus decrease the incidence of cerebral palsy. Despite this promise, a critique of clinical studies indicates that a definitive answer is dependent on the outcome of prospective clinical trials. A critique of experimental animal studies indicates that a neuroprotective role for magnesium prior to, or after, immature hypoxic-ischemic brain injury is currently not supported by the available evidence. Most clinical and animal studies in this field have used magnesium sulphate as a possible therapeutic agent. Based on evidence that magnesium chloride is a preferable salt to use, the inclusion of magnesium chloride in future clinical and experimental studies is worthy of consideration.