The Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years

Duley, L. ; Farrell, B. ; Armstrong, N. ; Spark, P. ; Roberts, B. ; Smyth, R. ; Tivnan, M. ; Laws, A. ; Corfield, N. ; Salter, A. ; Thorn, L. ; Altman, D. ; Yu, L.-M. ; Abalos, E. ; Carroli, B. ; Dellepiane, L. ; Duarte, M. ; Fernandez, H. ; Giordano, D. ; Clarke, M. ; Gray, A. ; Hey, E. ; Neilson, J. ; Simon, J. ; Collins, R. ; Karaoglou, A. ; Lilford, R. ; Moodley, J. ; Robson, S. ; Roberts, I. ; Rubin, P. ; Thornton, J. ; Twaddle, S. ; Villar, J. ; Walker, I. ; Watkins, C. ; Doyle, L. ; Bimbashi, A. ; Demalia, E. ; Gliozheni, O. ; Shpata, A. ; Karolinski, A. ; Lamas, M. ; Pesaresi, M. ; Wainer, V. ; Barbato, W. ; Paciocco, M. ; Bertin, M. ; Boiza, E. ; Castaldi, J. ; Partida, Y. ; Arias, C. ; Farri, M. ; Kerz, G. ; Aguirre, J. ; De Sagastizabal, M. ; Falcone, R. ; Morales, E. ; Carroli, G. ; Krupitzky, S. ; Lopez, S. ; Palermo, M. ; Montes, Varela D. ; Delprato, H. ; Camusso, H. ; Curioni, M. ; Ludmer, E. ; Brandi, R. ; Martin, R. ; Mesas, W. ; Taralli, R. ; Lezaola, M. ; Morosini, M. ; Andina, E. ; Bernal, L. ; Estiu, M. ; Ulens, E. ; Ortiz De Speranza, B. ; Peyrano, A. ; Damiano, M. ; Saumench, C. ; Horn, J. ; Pritchard, M. ; Smith-Orr, V. ; Wilson, M. ; Lawrence, A. ; Watson, D. ; Crowther, C. ; Paynter, J. ; Ashrafunnessa, ; Mannan, M. ; Shahidullah, M. ; Shamsuddin, L. ; Barros Santos, C. ; Freire, S. ; Melo, E. ; Cobo, E. ; Jaramillo, E. ; Cardozo, C. ; Fandino, N. ; Gaitan, H. ; Montano, L. ; Lozano, J. ; Rojas, M. ; Breto Garcia, A. ; Fuentes, Ramirez A. ; Garcia, Miras R. ; Sampera, S. ; Farnot, U. ; Gomez, E. ; Rojas, G. ; Valdes, R. ; Abd El-Kreem, H. ; Al-Hussaini, T. ; Hammad, E. ; Danso, K. ; Kwapong, E. ; Ofosu-Barko, E. ; Padmini Jasper, M. ; Peedicayil, A. ; Regi, A. ; Sharma, R. ; Chauhan, A. ; Raut, V. ; Udani, R. ; Batra, S. ; Muthal-Rathore, A. ; Ramji, S. ; Zutshi, V. ; Balakrishnan, S. ; Eapen, E. ; Koshy, G. ; Ambardar, N. ; Vadakkepat, P. ; Vaidya, D. ; Lema, V. ; Rijken, Y. ; Tadesse, E. ; Dada, O. ; Sofekun, A. ; Ohiaeri, C. ; Runsewe-Abiodun, T. ; Adewole, I. ; Adeyemo, A. ; Brown, B. ; Oladokun, R. ; Adewale, O. ; Inimgba, N. ; John, C. ; Ogu, R. ; Ekele, B. ; Isah, A. ; Onankpa, B. ; Jamelle, R. ; Junejo, D. ; Ruby, Faiz N. ; Gul, F. ; Sherin, A. ; Bangash, K. ; Mahmud, G. ; Masud, K. ; Tasneem, N. ; Gassama, S. ; Soyei, A. ; Agarwal, P. ; Rajadurai, V. ; Pirani, N. ; Delport, S. ; Macdonald, P. ; Mokhondo, R. ; Pattinson, R. ; Zondo, M. ; Adhikari, M. ; Mnguni, N. ; Moodley, J. ; Carstens, M. ; Kirsten, G. ; Steyn, W. ; Van Zyl, J. ; Helwig, A. ; Jacobson, S.-L. ; Panosche, R. ; Hammond, E. ; Masanganise, L. (2007)

Article

Objective: The aim of this study was to assess long-term effects for women following the use of magnesium sulphate for pre-eclampsia. Design: Assessment at 2-3 years after delivery for women recruited to the Magpie Trial (recruitment in 1998-2001, ISRCTN 86938761), which compared magnesium sulphate with placebo for pre-eclampsia. Setting: Follow up after discharge from hospital at 125 centres in 19 countries across five continents. Population: A total of 7927 women were randomised at the follow-up centres. Of these women, 2544 were not included for logistic reasons and 601 excluded (109 at a centre where <20% of women were contacted, 466 discharged without a surviving child and 26 opted out). Therefore, 4782 women were selected for follow-up, of whom 3375 (71%) were traced. Methods: Questionnaire assessment was administered largely by post or in a dedicated clinic. Interview assessment of selected women was performed. Main outcome measures: Death or serious morbidity potentially related to pre-eclampsia at follow up, other morbidity and use of health service resources. Results: Median time from delivery to follow up was 26 months (interquartile range 19-36). Fifty-eight 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). Conclusions: 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. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.

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