Do Women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomized placebo-controlled trial

The Magpie Trial Collaborative Group and Colditz, Paul B. (2002) Do Women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomized placebo-controlled trial. Lancet, 359 9321: 1877-1890. doi:10.1016/S0140-6736(02)08778-0


Author The Magpie Trial Collaborative Group
Colditz, Paul B.
Title Do Women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomized placebo-controlled trial
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
1474-547X
Publication date 2002-06
Sub-type Article (original research)
DOI 10.1016/S0140-6736(02)08778-0
Volume 359
Issue 9321
Start page 1877
End page 1890
Total pages 14
Place of publication London, UK
Publisher Elsevier Ltd
Language eng
Subject 11 Medical and Health Sciences
111402 Obstetrics and Gynaecology
Formatted abstract
Background

Anticonvulsants are used for pre-eclampsia in the belief they prevent eclamptic convulsions, and so improve outcome. Evidence supported magnesium sulphate as the drug to evaluate.

Methods


Eligible women (n=10 141) had not given birth or were 24 h or less postpartum; blood pressure of 140/90 mm Hg or more, and proteinuria of 1+ (30 mg/dL) or more; and there was clinical uncertainty about magnesium sulphate. Women were randomised in 33 countries to either magnesium sulphate (n=5071) or placebo (n=5070). Primary outcomes were eclampsia and, for women randomised before delivery, death of the baby. Follow up was until discharge from hospital after delivery. Analyses were by intention to treat.

Findings


Follow-up data were available for 10 110 (99·7%) women, 9992 (99%) of whom received the allocated treatment. 1201 of 4999 (24%) women given magnesium sulphate reported side-effects versus 228 of 4993 (5%) given placebo. Women allocated magnesium sulphate had a 58% lower risk of eclampsia (95% CI 40–71) than those allocated placebo (40, 0·8%, vs 96, 1·9%; 11 fewer women with eclampsia per 1000 women). Maternal mortality was also lower among women allocated magnesium sulphate (relative risk 0·55, 0·26–1·14). For women randomised before delivery, there was no clear difference in the risk of the baby dying (576, 12·7%, vs 558, 12·4%; relative risk 1·02, 99% CI 0·92–1·14). The only notable difference in maternal or neonatal morbidity was for placental abruption (relative risk 0·67, 99% CI 0·45–0·89).

Interpretation


Magnesium sulphate halves the risk of eclampsia, and probably reduces the risk of maternal death. There do not appear to be substantive harmful effects to mother or baby in the short term.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 241 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 733 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 13 Jul 2010, 11:51:16 EST by Laura McTaggart on behalf of Faculty Of Health Sciences