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In Reply: In response to Dr Ananth and colleagues, the primary purpose of reporting the combined outcome of death or substantial gross motor dysfunction is because the 2 components represent competing risks—a child cannot have motor dysfunction at 2 years if he or she has already died. Because we had found a significantly reduced number of survivors with gross motor dysfunction (reduced from 6.6% to 3.4%) it was important to establish that this was not achieved through an excess of deaths in the magnesium group.

With respect to counseling, parents usually want to know not only if their child will live, but if he or she will survive free of disability. Our data can be used to explain to parents that their child has an 83% chance of surviving free of gross motor dysfunction with use of magnesium sulfate compared with 77% without it. Parents should be advised that confirmation . . . [Full Text of this Article]

Caroline A. Crowther, MD, FRANZOG
caroline.crowther@adelaide.edu.au
Department of Obstetrics and Gynaecology

Janet E. Hiller, PhD
Department of Public Health
University of Adelaide
Adelaide, Australia

Lex W. Doyle, MD, FRACP
Departments of Obstetrics and Gynaecology and Paediatrics
University of Melbourne
Melbourne, Australia

Ross R. Haslam, FRACP
Department of Neonatal Medicine
Women's and Children's Hospital
Adelaide
For the Australasian Collaborative Trial of Magnesium Sulphate (ACTOMgSO4) Collaborative Group

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