Intended for healthcare professionals

Clinical Review State of the Art Review

Preterm birth and the role of neuroprotection

BMJ 2015; 350 doi: (Published 20 January 2015) Cite this as: BMJ 2015;350:g6661
  1. Eugene Chang, associate professor
  1. 1Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29492, USA
  1. Correspondence to: E Chang changey{at}


Preterm birth remains a common complication of pregnancy and causes substantial neonatal morbidity and mortality. As improvements in the care of preterm neonates have outpaced efforts to prevent preterm birth, the numbers of survivors with neurologic sequelae that affect quality of life have increased. The main strategies to reduce the impact of neurologic complications of prematurity include prevention of preterm birth and protection of the developing fetal brain through antenatal administration of drugs. These strategies rely on a basic understanding of the intertwined pathophysiology of spontaneous preterm labor and perinatal brain injury, which will be reviewed here. The review will outline current methods for the prevention of prematurity and neuroprotection. The use of magnesium sulfate as a neuroprotective compound will be discussed, including concerns over its association with increased pediatric mortality and abnormalities in bone density.


  • Contributors: EC is the sole contributor and will act as guarantor.

  • Competing interests: I have read and understood BMJ policy on declaration of interests and declare the following interests: none.

  • Provenance and peer review: Commissioned; externally peer reviewed.

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