INTRODUCTION: Recent data suggest a potential role for MgSO4 in the prevention of brain injury. From 1991-1994, we prospectively enrolled and followed a cohort of ventilated premature infants for assessment of early brain injury (intracranial hemorrhage [ICH] and large[>5 mm] cystic periventricular leukomalacia [PVL] and long-term neurodevelopmental outcome. METHODS: Our population consisted of 137 ventilated preterm infants (GA<33 weeks). Neuro-sonographic exams were performed weekly for ≥ 2 months. Surviving infants were followed in our high risk clinic. RESULTS: 61/137 (45%) mothers received MgSO4 prior to birth for tocolysis (n=46), pregnancy-induced hypertension (n=13), or both (n=2). Maternal, obstetrical, and perinatal characteristics in Yes-MgSO4 and No-MgSO4 groups were similar. 92/118 (78%) survivors were old enough (mean age 26.4 mo.) to have undergone neurodevelopmental testing with the Bayley Scales of Infant Development (BSID) and physical assessment for findings of cerebral palsy(CP). Compared to Yes-MgSO4 preterm infants, the No-MgSO4 neonates had an increased odds ratio (95% CI) of having Grade III or IV ICH or cystic PVL[OR=4.1 (2.0, 8.5)] and an increased odds ratio (95% CI) of having an adverse long-term neurodevelopmental outcome [OR=4.0 (1.6, 9.7)].CONCLUSION: Maternally-administered MgSO4 protects against early cerebral injury, as well as long-term adverse neurodevelopmental outcomes. Supported by NIH 5RO1 HD21453-06.Table

Table 1
Full size table