Serum magnesium level in the first trimester of pregnancy as a predictor of pre-eclampsia – a pilot study

Longitudinal Assessment of Calcium and Magnesium Levels in Women with Preeclampsia

The present study reports the levels of maternal serum calcium and magnesium from early pregnancy until delivery, along with cord levels, in women who developed preeclampsia (PE) and compares them with those without PE. A total of 324 pregnant women (216 non-PE and 108 PE women) were included in this retrospective case-control study of prospectively collected data nested in an observational cohort study. Maternal blood was collected at 4 time points during pregnancy (V1 = 11-14 weeks, V2 = 18-22 weeks, V3 = 26-28 weeks, and V4 = at delivery) and umbilical cord blood at delivery. Independent t tests were used to compare calcium, magnesium, and their ratio between two groups, and their associations with PE were studied using regression models. Calcium levels were similar between groups at all time points. Magnesium levels were lower (p = 0.021) at V2 in PE group as compared with non-PE group. Maternal calcium and magnesium levels were negatively associated, with blood pressure in early pregnancy. In fully adjusted logistic regression analysis, lower magnesium levels were associated with an increased risk of PE at V2 (OR 0.25 [95% CI 0.07, 0.94] p = 0.04). Lower magnesium in mid-pregnancy was associated with higher risk of PE. These changes were observed before the diagnosis of PE, thereby suggesting that they may have a role in the etiology of PE.

Association between trace elements and preeclampsia: A retrospective cohort study

BACKGROUND

Preeclampsia is the main cause of maternal and perinatal death. Multiple studies suggest that trace elements were associated with preeclampsia, but the results varied, and less known about early or mid-term pregnancy of trace elements and preeclampsia. We aim to explore the association between mid-term pregnancy trace elements levels and preeclampsia.

METHODS

The retrospective cohort study was consecutively conducted in Foshan Fosun Chancheng Hospital, Guangdong Province, China, from August 1, 2019, to November 30, 2019. Trace elements are derived from the laboratory data system, measured in maternal whole blood during 12-27 (+6) weeks of pregnancy by flame atomic absorption spectrometer method. Preeclampsia diagnosis and covariance were ascertained from the electronic medical records system. We used multivariable logical regression to estimate odds ratios (OR) and 95% CIs.

RESULTS

A total of 2186 participants were included in this study, and 59 (2.70%) women developed preeclampsia. After multivariable adjustment, the OR of Mg levels for preeclampsia was 0.35 (95%CI:0.06,2.20). The fifth quintiles of Mg were associated with 0.29 (95% CI：0.10,0.85) times lower risk of preeclampsia compared with the first quintile, with a dose-response trend (P for trend = 0.056). Per 1 µmol/L increment in Cu was associated with 11% lower risk of preeclampsia (OR=0.89; 95% CI, 0.78,1.02). Compared with the first quintile, the second, third，fourth，fifth quintile of Cu was associated with a odd ratio of 0.12 (95% CI:0.03,0.43),0.67 (95% CI:0.30,1.48),0.33 (95% CI:0.15,0.76) and 0.26 (95% CI:0.10,0.66),respectively. Null associations were observed for Zn, Fe, Ca.

CONCLUSIONS

Higher blood Mg and Cu levels in mid-term pregnancy were associated with lower preeclampsia risk.

Serum magnesium levels in normal pregnant women, severe preeclampsia, and severe preeclampsia with complications; a consideration for early supplementation?

OBJECTIVE

This study aims to compare serum magnesium levels of normal pregnant women, severe preeclampsia and severe preeclampsia with complications in the third trimester of pregnancy so that they can be used as a basis for earlier consideration of supplementation in pregnancy.

METHOD

This study was an observational study with a comparative cross-sectional design conducted in July-September 2019 in four hospitals in Makassar, namely Dr. Wahidin Soedirohusodo General Hospital, Hasanuddin University State University Hospital, Sitti Khadijah I Hospital and Children Hospital Siti Fatimah's Mother and Child Hospital. Respondents in this study were three-trimester pregnant women who were divided into three groups, 30 mothers with normal pregnancies, 30 mothers with severe preeclampsia, and 12 women with severe preeclampsia with complications. Criteria for respondents in this study were single pregnancy and not with systemic disease. Data collected included age, education, occupation, body mass index (BMI) before pregnancy, parity, the distance of pregnancy, history of preeclampsia, family planning history, history of antenatal care examination and pregnancy planning. Serum magnesium levels were determined using a Magnesium Assay Kit with a colorimetric method that was assessed for absorption by spectrophotometrics.

RESULTS

The mean serum magnesium levels were the lowest in the severe preeclampsia group (0.61mmol/L) compared to the severe preeclampsia group with complications (0.72mmol/L), and the normal pregnancy group (0.92mmol/L). Magnesium levels of the three groups differed significantly (p=0.008, p<0.05) CONCLUSION: Serum magnesium levels should be considered as a prognostic factor and supplementation intervention for pregnant women with preeclampsia.

Associations between the Level of Trace Elements and Minerals and Folate in Maternal Serum and Amniotic Fluid and Congenital Abnormalities

Congenital birth defects may result in a critical condition affecting the baby, including severe fetal/neonatal handicap and mortality. Several studies have shown that genetic, nutritional, and environmental factors may have an impact on fetal development and neonatal health. The relevance of essential and toxic elements on fetal development has not yet been fully investigated, and the results of recent research indicate that these elements may be crucial in the assessment of the risk of malformations in neonates. We determined the association between essential and toxic elements and the level of folate in maternal serum (MS) and amniotic fluid (AF), along with neonatal abnormalities. A total of 258 pregnant Polish women in the age group of 17⁻42 years participated in this study. AF and MS were collected during vaginal delivery or during cesarean section. An inductively coupled plasma mass spectrometry technique was used to determine the levels of various elements in AF and MS. The results of this exploratory study indicate that the levels of essential and toxic elements are associated with fetal and newborn anatomical abnormalities and growth disorders.