Doctors were able to dramatically cut the rate of disabling brain damage among premature babies using a remedy that is safe, widely available and costs just pennies a dose.

The wonder drug? A solution of magnesium sulfate, more commonly known as Epsom salts.

A study conducted at UNC Hospitals, Wake Forest Baptist University Medical Center and 18 other medical centers around the country found that giving women in early labor magnesium sulfate infusions reduced by nearly half the number of premature babies born with serious cases of cerebral palsy. Such children often are confined to wheelchairs and need help performing the most basic tasks, such as eating.

Results of the study, which involved 2,241 women at risk of preterm labor, were presented Thursday in Dallas at the annual meeting of the Society for Maternal-Fetal Medicine. About 4 percent of children born to women who got magnesium sulfate infusions had moderate or severe cerebral palsy when evaluated at age 2. Just over 7 percent of children born to women in the control group had moderate to severe cerebral palsy at the same age, the study found.

"It's sort of amazing that something so simple and cheap can have such an impact -- I really think this will change practice," said Dr. John Thorp, a UNC-CH obstetrician and study co-author. He said the treatment is already an established therapy for pregnancy-induced high blood pressure. It has also been used to try to slow preterm labor, with limited success.

Cerebral palsy, which is brain damage that can affect movement, speech and learning, is relatively rare, occurring in between two and three of every 1,000 babies born.

The condition is common among premature infants, who account for about one- third of all cases. Preemies' underdeveloped brains are more vulnerable to damage from oxygen loss, which can occur during labor. Thorp said doctors don't know exactly how magnesium sulfate helps, but it might improve blood flow to the brain and organs.

Dr. Dara Richardson-Heron, medical director for the national advocacy group United Cerebral Palsy, said the study results are promising. But she said it is hard to say how big an impact magnesium sulfate would have, because premature birth is just one of many causes of cerebral palsy.

An expensive disease

Still, in North Carolina -- which has one of the nation's highest rates of premature birth with 13.6 percent of babies born early annually -- broad use of magnesium sulfate could mean fewer children living with a condition that costs $920,000 per person over a lifetime. The estimate, prepared by the U.S. Centers for Disease Control and Prevention, includes medical costs such as power wheelchairs, home care and lost income and productivity.

Cerebral palsy "makes those lives more expensive and less productive than they could be," Thorp said. "It sure makes your life much more difficult."

Lisa Schwab of North Raleigh, whose 17-year-old son, Patrick, is severely impaired by cerebral palsy, can attest to that. Patrick is a bright and happy teenager, she said. But brain damage has left him unable to speak or walk. He drives a powered wheelchair. To communicate, he shakes his head or uses hand signals to indicate yes or no.

Schwab carried Patrick to full term, so she would not have been a candidate for magnesium sulfate had it been available when he was born. But Schwab said she is encouraged to see progress toward preventing some cases of such a profoundly disabling condition.

"This is great," said Schwab, who is a former board member of the state chapter of Easter Seals United Cerebral Palsy. She hopes this therapy will be routinely available to women in early labor.

Doctors treated 947 women in early labor with infusions of the study drug and gave 655 women in a control group drips of an inactive solution; the remainder of women in the study were ineligible for treatment, often because they delivered their babies too quickly for intervention. All the women were between 28 and 31 weeks into their pregnancies.

Magnesium sulfate did not affect rates of death among babies born to women in either group. Researchers observed a significant difference in cerebral palsy rates.

Treatment with magnesium sulfate did not have serious side effects in women or their babies. Thorp said UNC Hospitals is already offering magnesium sulfate to women in premature labor. He hopes more hospitals will do the same.

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