[Implementation of magnesium sulfate into clinical practice to reduce cerebral palsy and neurodisabilities in children born preterm].

The up-dated literature, notably the 2024 Cochrane review, and meta-analysis with individual data, as well as the identified socio-economic benefits, confirms that the administration of magnesium sulfate is recommended in women at risk of imminent preterm delivery before 32 weeks of gestation. In preterm infants, this intervention significantly reduces the risk of neonatal intracranial haemorrhage (moderate level of evidence), which is associated with an increased risk of subsequent neurodisabilities, as well as a very significant reduction in the risk of subsequent cerebral palsy in children (strong level of evidence). No effect on fetal, neonatal or infant mortality rates was observed. Given the still high rates of CP in the subgroup of children born between 30 and 32 or even 32-34 SA, and the absence of severe adverse events in both mother and child, it could be proposed to administer MgSO4 up to 34 SA (expert opinion). Magnesium sulfate is currently the only pharmacological molecule with a proven neuroprotective effect in preterm infants. It represents one of the means available to us to modulate the neurodevelopmental trajectory of the child, in particular the development of neuromotor skills. Optimization of administration methods is now a major challenge, with the aim of achieving an antenatal administration rate of over 90% in eligible patients. Further studies are needed to determine the optimal dosage, the timing of administration, the appropriateness and duration of the maintenance dose, the route of administration and, finally, the long-term outcome of children exposed to MgSO4 in the antenatal period.