Jan

UNC Psychiatry launches Forensic Psychiatry Program and Clinic

tahughes — 2008-02-15T20:14:49Z

Jan. 8, 2008

UNC Psychiatry launches Forensic Psychiatry Program and Clinic

The Department of Psychiatry in the University of North Carolina at Chapel Hill School of Medicine has expanded its psychiatric services in the forensic area with the opening of a new Forensic Psychiatry Program and Clinic.

The new program, which provides a wide range of criminal and civil services, such as determining the capacity of defendants in criminal cases to stand trial as well as the capacity of individuals in civil cases to manage their own finances or refuse treatment, is the only program of similar scope in North Carolina that is based on the campus of a major research university.

“This enables us to draw upon all of the other resources available through UNC-Chapel Hill and the UNC Health Care System,” said Dr. Sally C. Johnson, one of three clinicians who comprise the program’s evaluation and research team. “That is a tremendously helpful feature of our program, because completing comprehensive evaluations on individuals who need forensic psychiatry services often includes utilizing other medical and laboratory services. These services, as well as consultation with a variety of experts in other fields, are readily available at UNC. We hope that the research we are doing will ultimately prove helpful to the medical and legal professionals who are involved in the handling of cases where forensic psychiatry plays a role.”

Dr. Johnson brings to the program extensive experience from her career service as a public health physician and as an evaluator and administrator in the Federal Bureau of Prisons. She has conducted forensic psychiatry evaluations of defendants in many high-profile criminal cases, including former TV evangelist Jim Bakker, would-be presidential assassin John Hinckley and Theodore “Ted” Kaczynski (i.e., the “Unabomber”), which she conducted while employed as Chief Psychiatrist and Associate Warden of Health Services for the Federal Correctional Institution in Butner, N.C.

In addition to Dr. Johnson, team members include Dr. Alyson Kuroski-Mazzei, who also serves as Associate Training Director of the Forensic Psychiatry Fellowship Program for psychiatry residents who plan a career in this subspecialty area, and Dr. Eric Elbogen, a scientist-practitioner with specialized clinical and research expertise in forensic and neuropsychological assessments.

Research projects currently under way include a study of factors associated with increased risk of suicide and violence among Iraq and Afghanistan veterans and analyzing statutory language in juvenile sex offender laws in all 50 states. The goal of the latter project is to describe how juvenile sex offender laws define juvenile sex offenses and in what ways jurisdictions are similar or different, evaluating the key challenges and difficulties in applying such laws in the context of recent criminal cases.

This program allows attorneys, clinicians and clients to obtain focused or comprehensive assessments unique to their legal questions and needs. The program operates a clinic, housed in the North Carolina Neurosciences Hospital at UNC Hospitals, which will provide consultation and evaluations on an outpatient basis.

More information about the Forensic Psychiatry Program and Clinic and updates about clinic activities and training opportunities can be found at http://www.psychiatry.unc.edu/forensic/ or by calling (919) 966-5540.

Media contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu

ABOUT UNC HEALTH CARE
The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. UNC Health Care is comprised of UNC Hospitals, which is ranked among the top 50 in the nation in six specialties by U.S. News & World Report and ranked one of the country’s 41 best on the Leapfrog 2007 Top Hospitals list; the UNC School of Medicine, a nationally eminent research institution; community practices; home health and hospice services in seven central North Carolina counties; and Rex Healthcare and its provider network in Wake County. UNC Health Care also manages Chatham Hospital in Siler City.

People with anorexia less likely to be blamed when biology, genetics explained

tahughes — 2008-02-15T20:14:49Z

Jan. 9, 2008

People with anorexia less likely to be blamed when biology, genetics explained

People given a biological and genetics-based explanation for the causes of anorexia nervosa were less likely to blame people with anorexia for their illness than those given a sociocultural explanation, a University of North Carolina at Chapel Hill study found.

“This is a potentially important finding,” said first author Michele A. Crisafulli, “because it suggests that wider dissemination of information about the biological and genetic underpinnings of anorexia nervosa could help decrease the blame-based stigma that is associated with the disorder.”

The study was published Jan. 9, 2008, in the online version of the International Journal of Eating Disorders. It will be published in the print version of the journal later.

Crisafulli conducted the experimental study as an undergraduate honors thesis project while she was a student at UNC. She is currently working toward a doctoral degree in clinical psychology at Boston University.

“There is a lot of false information about anorexia nervosa disseminated in pop culture. This study suggests that even a nugget of accurate biological information can influence how health care professionals perceive the illness,” said Dr. Cynthia M. Bulik, William and Jeanne Jordan Distinguished Professor of Eating Disorders and Psychiatry, director of UNC’s Eating Disorders Program and the study’s senior author.

“It opens up new horizons for accurate information campaigns to help the public understand that people with anorexia nervosa are not to blame for their illness and that biology plays a role,” Bulik said.

Anorexia nervosa is characterized by the relentless pursuit to be thin and obsessive fears of being fat. Self-starvation, extreme weight loss and related medical complications that accompany the disorder can result in death. More people die from anorexia than from any other mental illness.

Anorexia nervosa is frequently perceived as something that is under the personal control of those who suffer from it, according to research cited as background information in the UNC study. As a result, many people tend to view those with anorexia as being responsible for their illness. This stigma is believed to create additional difficulties for people with the disease, including making them more reluctant to seek treatment.

In the UNC study, 115 undergraduate nursing students were first given a questionnaire that asked about the participants’ prior level of contact with people with anorexia nervosa. Then each was given a one-page information sheet. Roughly half received an information sheet that emphasized what is currently known about the biological and genetic contributions to the development of the disorder. The other half received an information sheet that emphasized sociocultural explanations for the causes of the illness.

After the students read the information they were given a second questionnaire in which they were asked to indicate on a seven-point scale the extent to which eight factors contributed to the development of anorexia. These factors were poor living habits, parenting, biological factors, lack of social support, self discipline, society’s thin ideal, genetic factors and vanity.

The questionnaire also asked other questions intended to measure the participants’ attitudes toward people with anorexia, including whether or not they would sign a petition asking insurance companies to provide equal coverage for anorexia as they do for other medical conditions.

The results showed that individuals in the group given the sociocultural explanation were more likely to agree with the statement, “They are to blame for their condition.” They were also more likely to agree that parenting, vanity and lack of social support were causes of anorexia nervosa.

The study concluded that “people who were presented with even minimal information about the biological and genetic underpinnings of (anorexia nervosa) did tend to blame people with anorexia for their condition less than are those who were only informed of the sociocultural factors that may contribute to the disorder.”

Ann Von Holle, a biostatistician at UNC, is a co-author.

To read the study, visit: http://www3.interscience.wiley.com/journal/34698/home

School of Medicine contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu
News Services contact: Clinton Colmenares, (919) 843-1991 or clinton_colmenares@unc.edu
Boston University contact: Bonnie Brown, (617) 353-9610 or bonnieb@bu.edu

UNC, Duke lead first statewide shaken baby prevention research project in U.S.

tahughes — 2008-02-15T20:14:49Z

Jan. 15, 2008

UNC, Duke lead first statewide shaken baby prevention research project in U.S.

Child abuse prevention experts from the University of North Carolina at Chapel Hill Injury Prevention Research Center and School of Medicine and Duke University Medical Center will undertake a $7 million statewide shaken baby prevention project.

The project, the largest and most comprehensive in the country, is funded by the Centers for Disease Control and Prevention, the Doris Duke Charitable Foundation and The Duke Endowment and is led by a broad coalition of stakeholders from the National Center for Shaken Baby Syndrome, University of British Columbia and state and county agencies, service providers and non-profit organizations.

State Sen. William Purcell and the North Carolina Child Fatality Task Force announced the project today, Jan. 15, 2008, in the legislative building in Raleigh. It is designed to reach the parents of every baby born each year in North Carolina with the goal of significantly reducing the number of deaths and serious injuries that occur when frustrated caregivers shake crying babies.

“In a baseline survey of parents of children younger than 2 years old in North Carolina, we found that more than 2,000 of these children are shaken, to a greater or lesser extent, by a caregiver each year and that serious injuries result for some,” said Dr. Desmond Runyan, a professor of social medicine and pediatrics at UNC and principal investigator for the project.

“However, only about 40 of these children are admitted to a hospital intensive care unit. Of those, 10 die and the other 27 suffer serious long-term health problems such as mental retardation, blindness, or cerebral palsy as a result,” Runyan said. “A lot more children are shaken who are not hospitalized but may have mental retardation or learning disabilities later. This shows the need for, and potential benefits of, preventing shaking.”

“As a pediatrician and a long-standing member of the N.C. Child Fatality Task Force, I know how devastating shaking a baby can be – to the infant and to the family. This project will share very important information that all parents can use about normal infant crying and how to manage that crying safely,” said Purcell, a retired pediatrician from Laurinburg, N.C., who has been actively involved with shaken baby prevention efforts for more than 10 years.

Previous research has shown that shaking babies is both common and a leading cause of infant mortality. Nationally, an estimated 1,200 to 1,400 children a year receive medical treatment after being shaken. An estimated 25 percent of these children die and 80 percent of survivors are left with some form of life-long brain injury.

Preliminary, unadjusted data from the baseline survey shows that almost one in 100 parents of children under 2 reported that they or their partner has shaken a child. Also, 1.3 percent of mothers in the survey reported having seen somebody other than their partner shake a child under 2 within the last year.

Jennipher Dickens’ son Christopher was shaken in 2006, when he was 7 weeks old, by another family member and now has permanent brain damage.

“Too many people in this state and all across the country have never heard of shaken baby syndrome and are unaware that shaking a baby is harmful,” said Dickens, of Windsor, N.C., who spoke at today’s announcement.

“Because he was shaken in a moment of anger and frustration, Christopher will suffer for the rest of his life. No baby should ever have to go through that pain and suffering.

“That’s why this program is so important. All parents and caregivers need to be educated on the fact that crying is normal, and should be taught healthy ways of coping with crying so they will know how to deal with frustration when the situation arises,” Dickens said. She created Stop Shaken Baby Syndrome Inc. (www.stopsbs.net) to promote prevention.

North Carolina’s project plans to provide every parent of the approximately 125,000 babies born in the state annually with an intervention program called “The Period of PURPLE Crying,” which was developed by Dr. Ron Barr, a professor of community child health research and a developmental pediatrician at the University of British Columbia, and Marilyn Barr, founder and executive director of the National Center on Shaken Baby Syndrome. Both Dr. Barr and Marilyn Barr are collaborating with the North Carolina project.

Dr. Barr created the concept of “The Period of PURPLE Crying” to help describe the characteristics of crying in healthy infants. “PURPLE” describes normal infant crying – it Peaks at 2 months of age and ends at 4 or 5 months, and often earlier; is Unexpected; Resists soothing; the child appears to be in Pain; it is Long lasting (2-5 hours); and occurs more in the Evening. The word “Period” lets parents know that this experience of increased, frustrating crying is temporary and eventually does come to an end.

The program includes hospital and health care provider-based parent education, a 10-minute video and an 11-page booklet that parents can share with other caregivers of their baby, such as family members and babysitters. The program educates parents and caregivers about the hazards of shaking and gives them alternatives to use when they feel they need a respite from a crying baby, such as handing off the baby to another caregiver or going to another room while leaving the baby in its crib with the rails up for periods of no longer than 15 minutes.

The co-principal investigator on the CDC research grant is Dr. Adam Zolotor of the UNC department of family medicine. In addition, Heidi Hennink-Kaminski and Elizabeth Dougall of the UNC School of Journalism and Mass Communication will work with the National Center on Shaken Baby Syndrome to develop a statewide media campaign to address social norms about shaking and reinforce program messages through caregivers, family, and friends.

The Center for Child and Family Health – a collaborative effort involving Duke University Medical Center, North Carolina Central University and the UNC School of Medicine focused on improving the standards of care for abused and traumatized children – will lead the implementation of the project. Dr. Robert Murphy, the center’s executive director and an associate professor of psychiatry at Duke and Margaret Samuels, center deputy director and Period of Purple Crying program manager, lead a statewide leadership team with Runyan that will foster the effort in more than 90 hospitals where children are born, as well as in community settings across the state.

“Our goal with this program is to protect those most vulnerable in our community by increasing awareness, especially among new parents, about proper childcare and the dangers of shaking,” Murphy said. “We hope these efforts will protect the long-term health and well-being of our newest generation.”

Funding for the project comes from three sources. The Centers for Disease Control and Prevention provided a five-year, $2.9 million grant and the Doris Duke Charitable Foundation provided a $2 million grant, both to the UNC Injury Prevention Research Center. Runyan is principal investigator for both of those grants. A third grant of $2 million from The Duke Endowment went to the Center for Child and Family Health, with Murphy as principal investigator, to fund implementation.

Note: Runyan can be reached at (919) 843-8261 or drunyan@unc.edu.
Murphy can be reached at (919) 419-3474 or robert.murphy@duke.edu.
Zolotor can be reached at (919) 843-4817 or ajzolo@med.unc.edu.
Dickens can be reached at (252) 724-0144 or jennipher@stopsbs.net.

UNC School of Medicine contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu

Duke News Service contact: Keith Lawrence, (919) 684-2823; (919) 812-6603 (after-hours) or keith.lawrence@duke.edu

Duke Medical Center News Office contact: Melissa F. Schwarting, (919) 660-1303, (919) 452-9633 or melissa.schwarting@duke.edu

4th Annual Krispy Kreme Challenge at N.C. State University to benefit North Carolina Children's Hospital

tahughes — 2008-02-15T20:14:49Z

January 22, 2008

4th Annual Krispy Kreme Challenge at N.C. State
University to benefit North Carolina Children's Hospital

RALEIGH, N.C. - One hour. Four miles. Twelve doughnuts. 2400 calories. Thousands of dollars to North Carolina Children's Hospital! North Carolina State University students and their supporters will participate in the fourth annual Krispy Kreme Challenge on Saturday, January 26, 2008, in an effort to raise money for North Carolina Children's Hospital in Chapel Hill. Nearly 1,400 students took part in last year's Krispy Kreme Challenge, and organizers expect more than 2,000 registrants this year.

Challenge participants run two miles from the N.C. State Belltower to the Krispy Kreme Doughnuts store on Peace Street, eat a dozen doughnuts, and then run two miles back to the Belltower. To successfully complete the Challenge, participants must complete the entire Challenge in less than 60 minutes.

The inaugural Krispy Kreme Challenge started as a dare among ten N.C. State students back in December 2004. When the Challenge made the pages of Sports Illustrated: On Campus the following year, word about the zany event quickly spread, and organizers decided to turn it into a charity fundraiser. The second annual Krispy Kreme Challenge in January 2006 drew more than 150 runners—40 of whom successfully completed the Challenge—and raised $800 for North Carolina Children's Hospital. Last year's third annual Challenge in January 2007 was exponentially more successful, drawing nearly 1,400 total participants and raising more than $10,000 for N.C. Children's Hospital. Approximately 600 runners successfully completed last year’s Challenge, one of them setting a new time record of 24:32.

The challenge has enjoyed the continued support of Herman Dubose, owner of the Peace Street Krispy Kreme store in Raleigh; Jim Micheels, owner of Raleigh Running Outfitters; and Raleigh-based apparel company, Bay Six USA. This year, local businesses such as Village Draft House and Ba Da Wings will support the event with corporate donations and donated prizes. This year’s prizes include a $100 gift card to Tir Na Nog Irish Pub, gift certificates to Harris Teeter, and $40 to Cameron Village’s Café Carolina and Bakery. Prizes will be awarded to the first five runners and first three teams who successfully complete the Challenge, as well as to the competitors who best exemplify the light-hearted spirit of the race. Last year’s top ten competitors all finished the Challenge in under 31 minutes, averaging less than 8 minutes per mile on the four-mile course.

Online registration is open at www.krispykremechallenge.com. For $15, participants can register as a full Challenger (i.e., committing to eat a dozen doughnuts) or a Casual Runner, eating as few doughnuts as they prefer. For companies and organizations that prefer to register a team of six or more runners, registration packets are also available by mail. The registration fee includes both the doughnuts and an event t-shirt. Casual spectators or supporters may additionally purchase t-shirts online for $10 each or make a general donation in the amount of their choice.

The Krispy Kreme Challenge will start at 9 a.m. on January 26, with onsite check-ins beginning at 8 a.m. at the N.C. State Belltower. There will be additional pre-race check-ins the week leading up to the race.

Members of the press are invited to cover this unique event. The public is also encouraged to attend and lend their support. Participants will run a route that takes them down Peace Street to the Krispy Kreme store at the intersection of Peace Street and Person Street. Spectators often arrive at the Krispy Kreme store as early as 8 a.m. in anticipation of the doughnut-eating spectacle, while others congregate at the N.C. State Belltower to witness the beginning and end of the race.

For more information about the Krispy Kreme Challenge, please visit www.krispykremechallenge.com.

The Krispy Kreme Challenge is not operated by Krispy Kreme Doughnut Corporation or its affiliates. The Krispy Kreme trademark and Bowtie logo are registered trademarks of HDN Development Corporation, and are used under license from HDN Development Corporation.

Hospital Media contact: Danielle M. Bates, 919-843-9714 or dbates@med.unc.edu

Krispy Kreme Challenge media contact: Theresa Crowgey, 919-920-1724
or Trcrowge@ncsu.edu

ABOUT NORTH CAROLINA CHILDREN'S HOSPITAL
Each year, more that 60,000 children from all 100 counties across the state make over 200,000 visits to North Carolina Children's Hospital. The hospital relocated to a state-of-the-art facility in 2002, which includes a comprehensive children's outpatient center and 136 inpatient beds in a child-friendly, family-focused environment. It is the first children's hospital in North Carolina to bring together complete inpatient and outpatient care in one location. For more information about North Carolina Children's Hospital, please visit the NCCH website at www.ncchildrenshospital.org.

ABOUT UNC HEALTH CARE
The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. UNC Health Care is comprised of UNC Hospitals, ranked consistently among the best medical centers in the country; the UNC School of Medicine, a nationally eminent research institution; community practices; home health and hospice services in seven central North Carolina counties; and Rex Healthcare and its provider network in Wake County.

Digital mammography superior to film mammography in some cases

tahughes — 2008-02-15T20:14:49Z

Jan. 29, 2008

Digital mammography superior to film mammography in some cases

For some women, digital mammography may be a better screening option than film mammography, according to newly published results from a national study led by a University of North Carolina at Chapel Hill researcher.

The results, from the Digital Mammographic Imaging Screening Trial (DMIST), appear in the February issue of Radiology. UNC’s Dr. Etta D. Pisano is principal investigator and lead author of the study, which found that digital mammography performed better than film mammography for pre- and perimenopausal women under age 50 with dense breasts.

“We looked at a cross-section of characteristics,” Pisano said. “This paper confirms that if you are under 50, pre- or perimenopausal, and have dense breasts, you should definitely be screened with digital rather than film.”

Pisano is Kenan professor of radiology and biomedical engineering and vice dean for academic affairs and in the UNC School of Medicine. She is also director of the Biomedical Research Imaging Center and a member of UNC Lineberger Comprehensive Cancer Center.

DMIST enrolled 49,528 women at 33 centers in the U.S. and Canada. The women underwent both digital and film mammography. Breast cancer status was determined for 42,760 women.

“The original DMIST results showed that digital was statistically similar to film in the overall screening population but performed better than film in pre- and perimenopausal women under 50,” Pisano said.

For this paper, the researchers sought to retrospectively compare the accuracy of digital mammography versus film mammography in subgroups defined by combinations of age, menopausal status and breast density, using either biopsy results or follow-up information.

They compared results in 10 different subgroups of women: pre- and perimenopausal women under age 50 with fatty breasts, pre- and perimenopausal women under age 50 with dense breasts, postmenopausal women under 50 with fatty breasts, postmenopausal women under 50 with dense breasts, pre- and perimenopausal women between the ages of 50 and 64 with fatty breasts, pre- and perimenopausal women age 50 to 64 with dense breasts, postmenopausal women age 50 to 64 with fatty breasts, postmenopausal women age 50 to 64 with dense breasts, women over age 65 with fatty breasts and women over 65 with dense breasts.

The results confirmed the trial’s original findings in favor of improved diagnostic accuracy of digital mammography over film for pre- and perimenopausal women under 50 years old with dense breasts. The findings also showed a trend toward improved diagnostic accuracy of film over digital mammography for women over 65 with fatty breasts. However, this finding was not statistically significant, and further investigation is needed to determine the reason that film performed slightly better in this subgroup. For other groups evaluated, there was no significant difference.

To read the study, go to: http://radiology.rsnajnls.org/

UNC Health Care media contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu

UNC Lineberger Comprehensive Cancer Center contact: Dianne Shaw, (919) 966-7834 or dgs@med.unc.edu

ABOUT UNC HEALTH CARE
The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. UNC Health Care is comprised of UNC Hospitals, which is ranked among the top 50 in the nation in six specialties by U.S. News & World Report and ranked one of the country’s 41 best on the Leapfrog 2007 Top Hospitals list; the UNC School of Medicine, a nationally eminent research institution; community practices; home health and hospice services in seven central North Carolina counties; and Rex Healthcare and its provider network in Wake County. UNC Health Care also manages Chatham Hospital in Siler City.

Lineberger joins Lance Armstrong Foundation Survivorship Network

tahughes — 2008-02-15T20:14:49Z

Jan. 28, 2008

Lineberger joins Lance Armstrong Foundation Survivorship Network

The Lance Armstrong Foundation today announced that the University of North Carolina at Chapel Hill’s Lineberger Comprehensive Cancer Center has joined the LIVESTRONG Survivorship Center of Excellence Network to address the needs of the growing number of cancer survivors in the United States. Lineberger is the eighth network member institution in the nation.

The network is an invitation-only collaborative partnership among the foundation, National Cancer Institute-designated comprehensive cancer centers at leading medical institutions nationwide and their community affiliates. The network seeks to harness the expertise, experience, creativity and productivity of leading centers and their community affiliates to help accelerate the pace of progress in addressing the needs of the growing survivor community. Working together, the network provides essential direct survivorship services and increases the effectiveness of survivorship care through research, the development of new interventions and sharing of best practices.

“We are highly honored to join the prestigious network, whose innovative work is directed at improving the lives of cancer patients,” said Dr. Shelley Earp, director of Lineberger. “The collaboration among UNC’s schools of Medicine and Public Health, in partnership with North Carolina communities, will help us understand how best to address the needs of survivors across the population.”

With this five-year $1.5 million grant, UNC will develop survivorship programs and services at the North Carolina Cancer Hospital and partnering sites around the state. In addition, UNC’s strategic plan includes regional and statewide outreach and education activities for patients, families and professionals. UNC program leaders, directed by Marci Campbell, Ph.D., foundation principal investigator and professor of nutrition in the UNC’s School of Public Health, plan to develop a peer counseling program to match survivors with trained peer counselors and create a Web site for the public and other materials/activities.

“Extended cancer survival is a relatively new phenomenon, so the current pace of research and of the development of effective models of care lags behind the need,” said Caroline Huffman, senior program officer at the foundation. “To help accelerate the pace of progress in addressing the needs of the growing survivor community, the foundation established the network to provide comprehensive, one-stop sources of information, care and services for people affected by cancer.”

Other network members include: Abramson Cancer Center, University of Pennsylvania, Philadelphia; Dana-Farber Cancer Institute, Boston; Fred Hutchinson Cancer Research Center, Seattle; Memorial Sloan-Kettering Cancer Center, New York; Ohio State University Comprehensive Cancer Center, Columbus; Jonsson Comprehensive Cancer Center, the University of California at Los Angeles; and the University of Colorado Cancer Center, Denver.

The Lance Armstrong Foundation unites people through programs and experiences to empower cancer survivors to live life on their own terms and to raise awareness and funds for the fight against cancer. The foundation focuses on cancer prevention, access to screening and care, research and quality of life for cancer survivors. Founded in 1997 by cancer survivor and champion cyclist Lance Armstrong, the foundation has raised more than $250 million for the fight against cancer.

For more about the Lance Armstrong Foundation Survivorship Network, visit www.LIVESTRONG.org.

Lineberger contact: Dianne Shaw, (919) 966-7834, dgs@med.unc.edu
News Services contact: Clinton Colmenares, (919) 843-1991, clinton_colmenares@unc.edu

Magnesium sulfate infusions reduce cerebral palsy risk in preterm births

tahughes — 2008-02-15T20:14:49Z

Jan. 31, 2008

Magnesium sulfate infusions reduce cerebral palsy risk in preterm births

Giving an infusion of magnesium sulfate just before delivery to pregnant women who were at high risk for preterm birth cut the rate of cerebral palsy in the children born by half, a new study found.

“This is one of the most promising breakthroughs in the management of high-risk pregnancies in more than 30 years,” said Dr. John Thorp, a study co-author and McAllister distinguished professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill.

“The active ingredient we used in this study, magnesium sulfate, is better known as Epsom salt,” Thorp said. “And virtually every delivery room in the United States is already stocked with magnesium sulfate solutions that are given to pregnant women during childbirth for other reasons.

“So what we have learned from this study is that we have a cheap, widely available treatment already in hand that cuts in half the risk of babies being born with an extremely disabling disorder. That is a tremendously exciting development,” Thorp said.

Results of the study will be presented Thursday (Jan. 31, 2008), at the annual meeting of the Society for Maternal-Fetal Medicine in Dallas. The lead author is Dr. Dwight J. Rouse of the University of Alabama at Birmingham. The study was conducted for the Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development, which provided grant funding. It took place at 20 sites across the United States, including UNC Hospitals.

In the study, 2,241 women who had been diagnosed at high risk for giving birth prematurely, between 24 and 31 weeks into their pregnancies, were randomized to receive an intravenous infusion of magnesium sulfate solution or an identically appearing placebo. The infusions were begun when delivery seemed imminent, at a rate of 6 grams infused over 20-30 minutes followed by a maintenance infusion of 2 grams per hour. If delivery did not occur within 12 hours, the infusion was stopped and resumed later when delivery once again appeared at hand.

The researchers were looking to see if magnesium sulfate reduced the rate of stillbirth or infant death, or reduced the rate of moderate or severe cerebral palsy at or beyond the age of 2 years. They found that the risk of death did not differ significantly between the magnesium sulfate and placebo groups. However, moderate or severe cerebral palsy occurred about half as often in the magnesium sulfate group than in the placebo group, 1.9 percent versus 3.5 percent.

An earlier study conducted in Australia, which included more than 3,000 women, reached similar results. Viewing both studies together, the researchers in the U.S. study concluded that the use of magnesium sulfate to prevent cerebral palsy in the children of women at imminent risk of early preterm delivery “should be strongly considered.”

Doctors who specialize in managing the pregnancies of women at high risk for preterm birth could begin using the magnesium sulfate treatment immediately, if they choose to do so, Thorp said. Approval for the treatment from the Food and Drug Administration is not required. In addition, the U.S. and Australian studies are the largest, most rigorously conducted and pertinent trials to date and are not likely to be replicated, Thorp said.

Society for Maternal-Fetal Medicine Web site: http://www.smfm.org/index.cfm?zone=publicintro

Note: Thorp can be reached at (919) 843-7851 or thorp@med.unc.edu.

School of Medicine contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu
News Services contact: Clinton Colmenares, (919) 843-1991 or clinton_colmenares@unc.edu