Research boost for mums

Oscar Straker, left, with mother Merryn and brother Louis, has cerebral palsy. Photo / Janna Dixon

Mothers who go into labour early may be offered magnesium sulphate to reduce the chance of their baby having cerebral palsy.

District health boards are deciding whether to offer the compound, after the New Zealand Guidelines Group recommended it be given before a pre-term birth, citing growing evidence that it can reduce the risk of cerebral palsy.

Ruth Martis, midwife representative on the guidelines group, said the simple and cheap compound seemed to have some "significant advantages" because it could calm hyperactivity in the baby's growing brain.

The recommendations, released at the Perinatal Society of Australia and New Zealand Congress in Wellington said women who are 28-30 weeks pregnant should have the drug within 24 hours of a predicted premature birth.

Further studies were being done to determine if magnesium sulphate was also effective outside of these timeframes.

Martis said more than 120 babies were born with cerebral palsy in New Zealand each year.

"This is a very important finding because few interventions have been found to prevent cerebral palsy, which can have devastating and long-term consequences," Martis said.

Cerebral palsy is a term that covers a number of conditions that can arise any time during a child's brain development. It can involve a disorder of movement or posture, or both, and a disorder of motor function which is permanent but which may change over time.

Martis said there could be side effects for mothers given magnesium sulphate, including nausea, vomiting, breathlessness and headaches. But it was an inexpensive drug and was used already with women for pre-eclampsia.

Cerebral Palsy Society of New Zealand general manager Harvey Brunt said he was aware of the research and felt there were good signals.

"Once cerebral palsy is there, there are no hopes that people can get rid of it. So the whole crux is about preventing it," he said.

National Women's clinical director of maternal fetal medicine, Emma Parry, said the hospital hopes to make a decision on magnesium sulphate on Wednesday.

Dr Alec Ekeroma, of Auckland's Middlemore Hospital, said the Counties Manukau District Health Board was still deliberating on the issue but was keen to look more into the research.

He said that he understood that magnesium sulphate could only benefit one in 40-60 children treated with it, so he wanted to make sure it was worthwhile.

While the compound itself was reasonably affordable, the costs were in staff giving the compound and monitoring the women after they were given it, he said.

Meanwhile, Martis said premature births were increasing, with about 640 births occurring before 30 weeks in New Zealand annually.

Forty-five per cent of all cerebral palsy cases were associated with pre-term births between 28-30 weeks.

Solution welcomed to a heartbreaking problem

Mother-of-two Merryn Straker says it is "highly exciting" that magnesium sulphate may help prevent some premature babies from being born with cerebral palsy. She hopes all district health boards will adopt its use.

The Auckland mum is 23 weeks pregnant and her baby is deemed perfectly healthy, but if a specialist recommended she take the drug to stop her unborn child getting the neurological disability she would do so.

"I don't know any mum who wouldn't take it if it would help."

This is because Merryn and husband Grant know what life can be like for a child with cerebral palsy. Their youngest son Oscar, 3, has the condition.

Merryn said her pregnancy and Oscar's birth seemed normal. It was not until he was 5 months old that she noticed he was behind in milestones compared with her other son Louis, now aged 4.

By 9 months, Oscar was not sitting unaided so she talked to Plunket because she was "a bit concerned".

He could sit up by 10 months but she went to see a paediatrician. An MRI scan at 18 months confirmed he had cerebral palsy.

Oscar has the condition at the medium end of the spectrum. He will eventually talk - he is trying to say words - but how clearly he will speak is unknown and his movement has been affected.

However, his cognitive ability, or mental skill, is not impaired; he is toilet trained and is coming along in leaps and bounds with his therapy through Conductive Education, which helps children with cerebral palsy.

"He has a lot of battles to overcome," Merryn Straker says.

However, Oscar loves to laugh with his brother, is "very determined" to do things and a "real character".

Merryn says her boy is precious and adored. But if anyone spent an afternoon with the family they would not hesitate in taking magnesium sulphate if it was recommended, she says.