From the Research
The Magpie Trial follow-up at 2 years showed that women who received magnesium sulfate for pre-eclampsia had similar long-term outcomes compared to those who received placebo. Women in both groups had comparable rates of death, serious morbidity, and quality of life measures at the 2-year follow-up point, as reported in the study published in BJOG: an international journal of obstetrics and gynaecology 1. The treatment did not appear to have any lasting negative effects on maternal health, which is reassuring given its proven short-term benefits in reducing eclampsia risk.
Key Findings
- The study found that 58 of 1650 (3.5%) women allocated magnesium sulphate died or had serious morbidity potentially related to pre-eclampsia compared with 72 of 1725 (4.2%) women allocated placebo (relative risk 0.84,95% CI 0.60-1.18) 1.
- The reduction in the risk of eclampsia following prophylaxis with magnesium sulphate was not associated with an excess of death or disability for the women after 2 years 1.
- Magnesium sulfate remains recommended for seizure prophylaxis in severe pre-eclampsia and eclampsia, typically administered as a 4-6g IV loading dose followed by 1-2g/hour maintenance infusion until 24 hours postpartum or after the last seizure.
Clinical Implications
- The follow-up results support the continued use of magnesium sulfate for its acute benefits without concerns about long-term maternal harm.
- This information is important for counseling women about the safety profile of this medication beyond the immediate peripartum period, as it suggests that the intervention, while effective for preventing seizures, does not significantly impact long-term maternal outcomes either positively or negatively.
- The findings of the Magpie Trial are consistent with other studies, such as the one published in The Lancet, which found that magnesium sulfate halves the risk of eclampsia and probably reduces the risk of maternal death 2.