The Magpie Trial: a randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years Magpie Trial Follow-Up Study Collaborative Group Correspondence: Dr L Duley, Magpie Trial Office, Nuffield Department of Medicine, Level 5, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK. Email lelia.duley@ndm.ox.ac.uk Accepted 4 October 2006. Published OnlineEarly 12 December 2006. Objective The aim of this study was to assess long-term effects for women following the use of magnesium sulphate for pre-eclampsia. Design Assessment at 2–3 years after delivery for women recruited to the Magpie Trial (recruitment in 1998–2001, ISRCTN 86938761), which compared magnesium sulphate with placebo for pre-eclampsia. Setting Follow up after discharge from hospital at 125 centres in 19 countries across five continents. Population A total of 7927 women were randomised at the follow- up centres. Of these women, 2544 were not included for logistic reasons and 601 excluded (109 at a centre where <20% of women were contacted, 466 discharged without a surviving child and 26 opted out). Therefore, 4782 women were selected for follow-up, of whom 3375 (71%) were traced. Methods Questionnaire assessment was administered largely by post or in a dedicated clinic. Interview assessment of selected women was performed. Main outcome measures Death or serious morbidity potentially related to pre-eclampsia at follow up, other morbidity and use of health service resources. Results Median time from delivery to follow up was 26 months (interquartile range 19–36). Fifty-eight of 1650 (3.5%) women allocated magnesium sulphate died or had serious morbidity potentially related to pre-eclampsia compared with 72 of 1725 (4.2%) women allocated placebo (relative risk 0.84, 95% CI 0.60–1.18). Conclusions The reduction in the risk of eclampsia following prophylaxis with magnesium sulphate was not associated with an excess of death or disability for the women after 2 years. Keywords Longterm follow-up, magnesium sulphate, pre-eclampsia, randomised trial. Please cite this paper as: Magpie Trial Follow-Up Study Collaborative Group. The Magpie Trial: a randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years. BJOG 2007;114:300–309. Introduction Pre-eclampsia complicates 2–8% of pregnancies. 1 Although outcome is often good, pre-eclampsia is a major cause of mater- nal and perinatal morbidity and mortality. 2–5 Whether pre- eclampsia has longer term consequences for the health of both the woman and her child is unclear, although hypertension during pregnancy does seem to be associated with an increase in cardiovascular mortality for the woman in her later life. 6,7 The Magpie Trial, 8 a large international study, is a rando- mised comparison of magnesium sulphate with placebo for women with pre-eclampisa. This trial showed that magne- sium sulphate halves the relative risk (RR) of eclampsia, with- out appearing to have substantive harmful effects on either the mother or the baby in the short term. 8,9 To date, there has been no reliable assessment of whether 8 magnesium sulphate influences long-term outcome following pregnancy compli- cated by pre-eclampsia. 10,11 We therefore contacted women recruited to the Magpie Trial when their children were 18 months or older. The main objective was to determine whether magnesium sulphate affects the child’s chance of surviving without neurosensory disability, and these data are reported elsewhere. 12 Secondary objectives, which are reported in this article, were to determine the effects of magnesium sulphate on longer term outcome for women to Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation. 300 ª 2006 The Authors Journal compilation ª RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology DOI: 10.1111/j.1471-0528.2006.01166.x www.blackwellpublishing.com/bjog Maternal medicine