BRAzil magnesium (BRAMAG) trial: a double-masked randomized clinical trial of oral magnesium supplementation in pregnancy

Abstract

Background: There is conflicting evidence about the role of oral magnesium supplementation in the prevention of preterm birth and related adverse outcomes. The objective of this study was to compare magnesium citrate with placebo in the prevention of adverse perinatal and maternal outcomes among women at higher risk. Methods: This multicenter, double-masked, placebo-controlled randomized superiority clinical trial compared oral magnesium citrate 300 mg to matched placebo, from 12 to 20 weeks' gestation until delivery. This trial was completed in three centers in northeastern Brazil. Eligible women were those with a singleton pregnancy and ≥ 1 risk factor, such as prior preterm birth or preeclampsia, or current chronic hypertension or pre-pregnancy diabetes mellitus, age > 35 years or elevated body mass index. The primary perinatal composite outcome comprised preterm birth < 37 weeks' gestation, stillbirth > 20 weeks, neonatal death or NICU admission < 28 days after birth, or small for gestational age birthweight < 3rd percentile. The co-primary maternal composite outcome comprised preeclampsia or eclampsia < 37 weeks, severe gestational hypertension < 37 weeks, placental abruption, or maternal stroke or death during pregnancy or ≤ 7 days after delivery. Results: Analyses comprised 407 women who received magnesium citrate and 422 who received placebo. The perinatal composite outcome occurred among 75 (18.4%) in the magnesium arm and 76 (18.0%) in the placebo groupan adjusted odds ratio (aOR) of 1.10 (95% CI 0.72-1.68). The maternal composite outcome occurred among 49 (12.0%) women in the magnesium arm and 41 women (9.7%) in the placebo groupan aOR of 1.29 (95% CI 0.83-2.00). Conclusions: Oral magnesium citrate supplementation did not appear to reduce adverse perinatal or maternal outcomes in high-risk singleton pregnancies. Trial registration: ClinicalTrials.gov NCT02032186, registered January 9, 2014.

Micronutrient supplementation interventions in preconception and pregnant women at increased risk of developing pre-eclampsia: a systematic review and meta-analysis

“…pharmacological intervention) and retraction of trials. Twenty articles [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] met the inclusion criteria and were included in this review. The study identification and selection process are summarised in Fig.…”

Evidence-Based Recommendations for an Optimal Prenatal Supplement for Women in the U.S., Part Two: Minerals

“…The Angola study also reported a substantial reduction in the rate of edema (24% vs. 58%, respectively). However, a study of magnesium supplementation (300 mg/day of elemental magnesium) in Brazil [108] did not find any effect on perinatal composite outcome (preterm birth, stillbirth, neonatal death, NICU admission, or small-for-gestational-age birthweight) or for maternal composite outcome (preeclampsia, eclampsia, gestational hypertension <37 weeks, placental abruption, or maternal stroke or death during pregnancy or ≤7 days after delivery). Therefore, the effects of magnesium supplementation may vary between countries.…”

A call to leverage a health equity lens to accelerate human neuroscience research

“…Historical structural factors set the tone for the present-day environment in which human neuroscience research operates: mainly intergenerational wealth- and privilege- dominated ( Abiodun, 2019 ). One such example of historical context leaving lasting impact on today’s structural resources is colonialism, which has resulted in lasting changes in power and resources for entire communities that pesrist today ( Czyzewski, 2011 ; Sherwood, 2014 ; Araújo et al, 2020 ). These historical structural factors continue to influence current contextual factors surrounding brain health and may have implications for neurodevelopmental and psychiatric disorders in later life ( Gajwani and Minnis, 2022 ).…”