A program to increase the use of magnesium sulfate, a £1 injection that helps prevent cerebral palsy in premature babies, is effective according to a National Institute for Health and Care Research (NIHR) funded evaluation. The findings, led by researchers at the University of Bristol, are published in the Archives of Disease in Childhood.
Premature birth is the main cause of brain injury and cerebral palsy in babies. Evidence shows that babies can be protected from brain injury by giving magnesium sulfate to women who are at risk of premature birth. This reduces the risk of cerebral palsy by a third. However, in 2017 only 64% of eligible women were being given magnesium sulfate in England, Scotland and Wales.
The prevention of cerebral palsy in pre-term labour (PReCePT) programme aimed to support all maternity units in England to increase the use of magnesium sulfate in premature births. The PReCePT approach was developed in the West of England in 2014. It was led by the West of England Academic Health Science Network (AHSN) and University Hospitals Bristol and Weston NHS Foundation Trust.
It was then piloted in five NHS trusts in the West of England, and this pilot was evaluated by the NIHR Applied Research Collaboration West (NIHR ARC West). It has since been rolled out across England via the AHSN Network as a national programme.
The evaluation of the national program, also led by NIHR ARC West, found that PReCePT was both effective and cost-effective. The researchers looked at data from the UK National Neonatal Research Database for the year before and year after PReCePT was implemented in maternity units in England.
While use of magnesium sulfate had been increasing before, the study showed that PReCePT was able to accelerate uptake. It increased by 6.3 percentage points on average across all maternity units in England during the first year, over and above the increase that would be expected over time as the practice spread organically. After also adjusting for variations in when maternity units started the programme, the increase in use of magnesium sulfate was 9.5 percentage points. By May 2020, on average 86.4% of eligible mothers were receiving magnesium sulfate.
The researchers also estimated that the program’s first year could be associated with a lifetime saving to society of £3 million. This accounts for the costs of the program, administering the treatment and of cerebral palsy to society over a lifetime, and the associated health gains of avoiding cases. This is across all the extra babies the program helped get access to the treatment during the first year.
