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Antenatal magnesium sulfate to prevent cerebral palsy
  1. Amy K Keir1,2,3,
  2. Emily Shepherd1,
  3. Sarah McIntyre4,
  4. Alice Rumbold1,2,
  5. Charlotte Groves3,
  6. Caroline Crowther5,
  7. Emily Joy Callander6
  1. 1 SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
  2. 2 Adelaide Medical School and the Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
  3. 3 Women's and Babies' Division, Women's and Children's Hospital, Adelaide, North Adelaide, South Australia, Australia
  4. 4 Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, New South Wales, Australia
  5. 5 Liggins Institute, The University of Auckland, Auckland, New Zealand
  6. 6 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Amy K Keir, SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide 5006, South Australia, Australia; amy.keir{at}


Magnesium sulfate given to women before birth at <30 weeks’ gestation reduces the risk of cerebral palsy in their children. Our study aimed to assess the impact of a local quality improvement programme, primarily using plan-do-study-act cycles, to increase the use of antenatal magnesium sulfate. After implementing our quality improvement programme, an average of 86% of babies delivered at <30 weeks’ gestation were exposed to antenatal magnesium sulfate compared with a historical baseline rate of 63%. Our study strengthens the case for embedding quality improvement programmes in maternal perinatal care to reduce the impact of cerebral palsy on families and society.

  • health services research
  • neonatology

Data availability statement

Data (de-identified only) are available upon reasonable request.

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Data availability statement

Data (de-identified only) are available upon reasonable request.

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  • Twitter @AmyKKeir, @EmilyCallander

  • Contributors AKK and EJC had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: AKK and EJC. Acquisition, analysis or interpretation of data: all authors. Drafting of the manuscript: AKK initial draft and then all authors. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: EJC and AKK.

  • Funding The Health Services Charitable Gifts Board (HSCGB) generously funds the salary of the nursing and midwifery co-leads for the QI programme. AKK and EJC are in receipt of National Health and Medical Research Council (NHMRC) Fellowships (APP1161379 and APP1159536, respectively).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.