THE ISSUE: Cerebral palsy is infrequent, but causes devastating neurologic consequences in preterm infants. Three recent randomized trials and several metaanalyses have evaluated the role of antenatal magnesium sulfate for neuroprotection in patients at risk for early preterm delivery. Despite the recommendations from the metaanalyses, there is uncertainty about whether to treat or who to treat, if any, with magnesium sulfate.