***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: OBJECTIVES We tested the hypothesis that administration of magnesium sulfate in labor protects against the development of neonatal brain lesions and cerebral palsy ( CP ) in low birth weight infants . METHODS Magnesium exposure was ascertained in a population -based cohort of 1105 infants weighing 2000 g or less through review of medical records of maternal magnesium sulfate administration and , where available , elevated maternal serum magnesium levels . Neonatal germinal matrix/intraventricular hemorrhage and parenchymal brain lesions were ascertained by a prospect i ve , timed ultrasound scanning protocol in the first week of life . CP was ascertained at 2 years of age by clinical examination in 80 % of survivors and by interview and medical record review in another 6 % and was classified as disabling or nondisabling . RESULTS No significant reduction in risk of nondisabling CP ( adjusted odds ratio [ OR ] , 1.00 ; 95 % confidence interval [ CI ] , 0.53 to 1.88 ) or disabling CP [ DCP ] ( adjusted OR , 0.63 ; 95 % CI , 0.32 to 1.24 ) CP with magnesium exposure was found in a logistic regression model that controlled for gestational age , fetal growth , gender , multiple birth status , mode of delivery , amnionitis , and hypertensive disorders . In a small subset of infants , those with onset of parenchymal lesions at 7 days of age or later ( n = 29 ) , magnesium exposure was associated with a significantly reduced risk of DCP ( OR , 0.10 ; 95 % CI , 0.02 to 0.65 ) . Magnesium sulfate exposure was not associated with germinal matrix/intraventricular hemorrhage ( adjusted OR , 0.89 ; 95 % CI , 0.64 to 1.25 ) or with parenchymal brain lesions ( adjusted OR , 0.83 ; 95 % CI , 0.53 to 1.30 ) . CONCLUSIONS The hypothesis that magnesium sulfate use reduces the risk of neonatal brain lesions or CP in low birth weight infants was not statistically supported in this study , although a modest reduction in risk of DCP can not be excluded . The data further suggest that magnesium exposure may be associated with reduction in risk of CP in low birth weight infants who have late-onset brain lesions , but this unpredicted observation requires confirmation in another data set OBJECTIVES To investigate whether in utero exposure to magnesium sulfate ( MgSO4 ) was associated with a lower prevalence of  cerebral palsy ( CP ) in infants born weighing < 1500 g. DESIGN Singleton infants weighing < 1500 g at birth ( very low birthweight , VLBW ) and surviving to 3 years with moderate or severe congenital CP were identified among 155,636 children born 1983 through 1985 in four California counties . VLBW children with CP were compared with r and omly selected VLBW control survivors with respect to whether their mothers received MgSO4 to prevent convulsions in preeclampsia or as a tocolytic agent , and other information abstract ed from labor and delivery records . RESULTS During the admission for delivery , 7.1 % of the 42 VLBW infants with later CP and 36 % of the 75 VLBW controls were exposed to MgSO4 ( odds ratio ( OR ) .14 , 95 % confidence interval ( CI ) .05 , .51 ) . The overall association of MgSO4 with reduced risk of CP was also observed in the subgroup of infants born to women who were not preeclamptic ( OR .25 , CI .08 , .97 ) . Infants with CP were less often exposed antenatally to MgSO4 whether or not there was cotreatment with  non-MgSO4 tocolytics  ( other tocolytics administered , OR for MgSO4 exposure .23 , CI .06 , 1.2 ; other tocolytics not administered , OR for MgSO4 .08 , CI .02 , .68 ) , or  antenatal corticosteroids  ( steroids given , OR for MgSO4 exposure .24 , CI .06 , 1.3 ; steroids not given , OR for MgSO4 , .08 , CI .02 , .72 ) . Apparent benefit of magnesium was observed in the presence or absence of a variety of characteristics of pregnancies , births , and infants . CONCLUSION In this observational study , in utero exposure to MgSO4 was more frequent in controls than in children with CP , suggesting a protective effect of MgSO4 against CP in these VLBW infants DESIGN AND METHODS We hypothesized that treatment with recombinant human erythropoietin ( r-HuEPO ) would stimulate erythropoiesis and would thereby reduce the need for erythrocyte transfusions in preterm infants . We treated 157 preterm infants born at 26.9 + /- 1.6 weeks of gestation who weighed 924 + /- 183 g at birth with either subcutaneous r-HuEPO ( 100 U/kg/d , 5 days per week ) or placebo for 6 weeks in a r and omized , double-blind , controlled clinical trial . All patients received oral iron and were managed according to uniform conservative transfusion guidelines . RESULTS Treatment with r-HuEPO was associated with fewer erythrocyte transfusions ( 1.1 + /- 1.5 per infant in the r-HuEPO group versus 1.6 + /- 1.7 per infant in the placebo group ; P = .046 ) and with a reduction in the volume of packed erythrocytes transfused ( 16.5 + /- 23.0 mL versus 23.9 + /- 25.7 mL per infant ; P = .023 ) . Overall , 43 % of the infants in the r-HuEPO group and 31 % of placebo-treated infants were transfusion-free during the study ( P = .18 ) . The volume of blood removed for laboratory tests and the need for respiratory support at the start of treatment had major effects on transfusion requirements independent of r-HuEPO . Reticulocyte counts were higher during treatment in the r-HuEPO group ( P = .0001 ) , and r-HuEPO-treated infants had higher hematocrit values at the end of the study ( 32 % versus 27.3 % in the placebo group ; P = .0001 ) . We found no differences in the incidence of major complications of prematurity between the treatment groups . CONCLUSION We conclude that treatment with r-HuEPO at a weekly dose of 500 U/kg stimulates erythropoiesis , moderates the course of anemia , is associated with a reduction in erythrocyte transfusions , and appears safe in very low birth weight preterm infants who are receiving iron supplements . Conservative transfusion criteria , minimization of phlebotomy losses , and treatment with r-HuEPO are complementary strategies to reduce erythrocyte transfusions in these infants BACKGROUND Research suggests that fetal exposure to magnesium sulfate before preterm birth might reduce the risk of cerebral palsy . METHODS In this multicenter , placebo-controlled , double-blind trial , we r and omly assigned women at imminent risk for delivery between 24 and 31 weeks of gestation to receive magnesium sulfate , administered intravenously as a 6-g bolus followed by a constant infusion of 2 g per hour , or matching placebo . The primary outcome was the composite of stillbirth or infant death by 1 year of corrected age or moderate or severe cerebral palsy at or beyond 2 years of corrected age . RESULTS A total of 2241 women underwent r and omization . The baseline characteristics were similar in the two groups . Follow-up was achieved for 95.6 % of the children . The rate of the primary outcome was not significantly different in the magnesium sulfate group and the placebo group ( 11.3 % and 11.7 % , respectively ; relative risk , 0.97 ; 95 % confidence interval [ CI ] , 0.77 to 1.23 ) . However , in a prespecified secondary analysis , moderate or severe cerebral palsy occurred significantly less frequently in the magnesium sulfate group ( 1.9 % vs. 3.5 % ; relative risk , 0.55 ; 95 % CI , 0.32 to 0.95 ) . The risk of death did not differ significantly between the groups ( 9.5 % vs. 8.5 % ; relative risk , 1.12 ; 95 % CI , 0.85 to 1.47 ) . No woman had a life-threatening event . CONCLUSIONS Fetal exposure to magnesium sulfate before anticipated early preterm delivery did not reduce the combined risk of moderate or severe cerebral palsy or death , although the rate of cerebral palsy was reduced among survivors . ( Clinical Trials.gov number , NCT00014989 . OBJECTIVE To estimate whether higher magnesium levels in umbilical cord blood at delivery are associated with increased total pediatric ( fetal + neonatal + postneonatal ) mortality . METHODS During the Magnesium and Neurologic Endpoints Trial , in addition to r and omizing mothers having preterm labor into arms containing magnesium sulfate , other tocolytic agents , or saline controls , we obtained biologic specimens at delivery , including umbilical cord venous blood on which was determined the serum ionized magnesium level using the AVL 988–4 analyzer ( Graz , Austria ) . Laboratory results were then matched with the pediatric mortalities . The study power was based on the anticipated reductions in neonatal intraventricular hemorrhage related to magnesium usage from 18.9 % to 4.4 % . For & agr ; = .05 , 1 − β ( power ) = 80 % , two tailed , the total number of infants needed would be 140 . RESULTS Of 149 mothers who gave permission for r and omization , ionized magnesium levels were available for 82 children . Seven deaths occurred ( one immediately before delivery , three as neonates , and three in the postneonatal period ) . The median level of ionized magnesium among the seven dead children was 0.76 mmol/L ; among the 75 survivors , the median level of ionized magnesium was 0.55 mmol/L ( Mann‐Whitney U test , P = .03 ) . Using multivariable logistic regression analysis , the association remained statistically significant when controlling for possible confounding factors ( adjusted odds ratio 7.7 , 95 % confidence interval 1.2 , 47.6 , P = .03 ) . CONCLUSION These findings of a dose response between serum ionized magnesium and deaths in children increase our concern about the improper use of tocolytic magnesium OBJECTIVES To determine the changes with postnatal age for survival , with and without major sensorineural disability , to 5 years of age in very preterm infants and to contrast their prognosis with normal birth weight ( NBW ) control participants . METHODS A geographically determined cohort study was conducted in Victoria , Australia . Consecutive live births of 23 to 27 weeks ' gestational age born during 1991 to 1992 and r and omly selected contemporaneous NBW control participants were studied . The main outcome measures were survival and rates of major disability at 5 years of age , determined for those offered intensive care , after day 7 , after day 28 , and at hospital discharge . RESULTS Of 401 live births of 23 to 27 weeks ' gestation , 225 ( 56.1 % ) survived to 5 years of age . The survival rate rose significantly with increasing gestational age at birth in those offered intensive care and by day 7 but not by day 28 . The survival rate free of major disability rose significantly with increasing gestational age at all postnatal ages but was not an independent predictive variable by day 28 ; other adverse events were more important . In the absence of adverse events , the rate of survival free of major disability for very preterm infants who had survived to discharge was 93.2 % , similar to the rate of 95.5 % for NBW control participants . CONCLUSIONS The prognosis for very preterm infants changes substantially with postnatal age . Counseling of families should be repeated at intervals , and the advice offered should vary with perinatal events OBJECTIVE To determine the survival and sensorineural disability rates in very preterm infants born in 1991 - 92 , and to compare the results with contemporaneous normal birthweight controls and with preterm infants born in 1985 - 87 . METHODOLOGY This was a geographically determined cohort study in the state of Victoria , Australia of consecutive livebirths 23 - 27 weeks ' gestational age born during 1991 - 92 , and r and omly selected contemporaneous normal birthweight ( NBW ) controls born during 1991 - 92 in the three level-III perinatal centres in the State . Consecutive livebirths 24 - 26 weeks gestational age born in the State during 1985 - 87 comprised another comparison group . The main outcome measures were survival and sensorineural disability rates at 2 years of age . RESULTS Of the 401 livebirths 23 - 27 weeks in 1991 - 92 , 225 ( 56.1 % ) survived 
    Output:
    
There were also no significant effects of antenatal magnesium therapy on combined rates of mortality with neurologic outcomes .