PReCePT – using magnesium sulphate to reduce cerebral palsy in pre-term babies

As part of its Maternity and Neonatal Safety Improvement Programme, the National Patient Safety Team has been working with the Patient Safety Collaboratives* since 2018 to support maternity units across England, through the PReCePT (Prevention of cerebral palsy in pre-term labour) initiative, to help prevent cerebral palsy in pre-term babies through the increased practice of giving magnesium sulphate to women in pre-term labour.

Due to the successes of PReCePT and the continued requirement to advocate the use of magnesium sulphate in clinical practice, its use has been spread and is now reliably used in all maternity units nationally.

The PReCePT initiative has helped increase magnesium sulphate uptake to a national average in 2021 of 88.5% eligible women being treated, with a range between 86.8% to 92.1% across different parts of the country. This means that every area in England has reached and sustained the original 85% ambition, with seven out of fifteen Patient Safety Collaborative geographical areas achieving a magnesium sulphate take-up rate of more than 90% for eligible women.  

When a baby suffers cerebral palsy, this has significant implications for them throughout their lives, affects their families and carers, and means more costs to them, their families and the health and care system. Giving magnesium sulphate during preterm labour is projected to have the following outcomes:

  • For every 37 women receiving magnesium sulphate, one fewer baby will be affected by cerebral palsy.
  • Between April 2018 and March 2023, 14,270 eligible women have received magnesium sulphate, protecting more than 16,000 babies (including multiple births), resulting in an estimated 385 fewer cases of cerebral palsy (from the launch of the NHS Patient Safety Strategy in 2019, there have been an estimated 291 fewer cases of cerebral palsy).
  • Since 2018, this work has resulted in financial cost avoidance of up to £385 million (based on cost avoidance of between £0.8 to £1 million lifetime costs per affected baby with cerebral palsy).

The Maternity and Neonatal Safety Improvement Programme is part of the wider National Patient Safety Improvement Programmes, which are a key part of the NHS Patient Safety Strategy, to deliver safety and quality improvements across the NHS in England. The impact of these programmes play a major part in progress towards meeting the ambition of the NHS Patient Safety Strategy, to save an additional 1,000 lives and £100 million per year. Find out more on our NHS Patient Safety Strategy webpage.

The PreCePT programme is one of seven interventions that form part of the Maternity and Neonatal Safety Improvement Programme’s preterm optimisation pathway. You can find out more about the programme:

*The Patient Safety Collaboratives are an improvement arm of 15 academic health science networks, who support with driving improvement and managing change at system level. The National Patient Safety Team work collectively with the collaboratives, who help to tailor our improvement programmes based on local situations which vary from place to place. The collaboratives are a conduit for the national team and local providers and their role in the delivery of the national programme is vital.