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In RCTs, reductions in neonatal death with magnesium sulphate versus placebo or no treatment (risk ratio [RR]\u2009=\u20090.68; 95% confidence interval [CI]\u2009=\u20090.53\u20130.86; 13 RCTs), and magnesium sulphate with melatonin versus melatonin alone (RR\u2009=\u20090.74; 95% CI\u2009=\u20090.58\u20130.95; one RCT) were observed. No difference in neonatal death was seen for magnesium sulphate with therapeutic hypothermia versus therapeutic hypothermia alone (RR\u2009=\u20090.66, 95% CI\u2009=\u20090.34\u20131.26; three RCTs), or magnesium sulphate versus phenobarbital (RR\u2009=\u20093.00; 95% CI\u2009=\u20090.86\u201310.46; one RCT). No reduction in death or long\u2010term neurodevelopmental disability (RR\u2009=\u20090.52; 95% CI\u2009=\u20090.14\u20131.89; one RCT) but reductions in several short\u2010term adverse outcomes were observed with magnesium sulphate. Evidence was low\u2010 to very\u2010low certainty because of risk of bias and imprecision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Given the uncertainty of the current evidence, further robust neonatal magnesium sulphate research is justified. This may include high\u2010quality studies to determine stand\u2010alone effects in LMICs and effects with and after therapeutic hypothermia in high\u2010income countries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.15899","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T06:19:05Z","timestamp":1710224345000},"page":"1157-1172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Neonatal magnesium sulphate for neuroprotection: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2608-2061","authenticated-orcid":false,"given":"Emily","family":"Shepherd","sequence":"first","affiliation":[{"name":"Women and Kids Theme, South Australian Health and Medical Research Institute  Adelaide South Australia Australia"},{"name":"Adelaide Medical School The University of Adelaide  Adelaide South Australia Australia"},{"name":"Cerebral Palsy Alliance Research Institute, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasneem","family":"Karim","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Alliance Research Institute, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0234-1541","authenticated-orcid":false,"given":"Sarah","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Alliance Research Institute, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3903-6142","authenticated-orcid":false,"given":"Shona","family":"Goldsmith","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Alliance Research Institute, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Keir","sequence":"additional","affiliation":[{"name":"Women and Kids Theme, South Australian Health and Medical Research Institute  Adelaide South Australia Australia"},{"name":"Adelaide Medical School The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Badawi","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Alliance Research Institute, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Grace Centre for Newborn Intensive Care The Children's Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2446-1739","authenticated-orcid":false,"given":"Rod W.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Alliance Research Institute, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Paediatrics Monash University  Melbourne Victoria Australia"},{"name":"Monash Newborn Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Galinsky","sequence":"additional","affiliation":[{"name":"The Ritchie Centre, Hudson Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization (WHO).Newborns: improving survival and well\u2010being. 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