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To the Editor: Dr Crowther and colleagues¹ reported that the occurrence of a secondary, composite variable defined as "death or substantial motor dysfunction at a corrected age of 2 years" was significantly lower in the group exposed to magnesium sulfate. None of the individual outcomes, including cerebral palsy, was significantly different between the groups, although each was less common in the magnesium sulfate group.

Because this was a trial of prevention using magnesium sulfate in comparatively low doses, the results cannot be generalized to the current US use of magnesium sulfate for tocolysis, for which the typical regimen comprises a 4- to 6-g rapid loading dose followed by maintenance infusions ranging from 2 to 4 g/h for 24 hours or more (thus, total exposures of 50 g).

By contrast, the median total (loading plus infusion) dose of magnesium sulfate administered in the study by Crowther et al was less than . . . [Full Text of this Article]

Robert Mittendorf, MD, DrPH
rmitten@lumc.edu
Department of Obstetrics and Gynecology
Loyola University Medical Center
Maywood, Ill

Kwang-Sun Lee, MD
Section of Neonatology
Department of Pediatrics
University of Chicago Children's Hospital
Chicago, Ill

Nancy J. Roizen, MD
SUNY Upstate Medical University
Syracuse, NY

Peter G. Pryde, MD
University of Wisconsin Medical School
Madison

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