Abstract
BackgroundPreeclampsia is the major cause of maternal morbidity and mortality in developing countries. Magnesium sulfate is considered first-line therapy against eclampsia and magnesium deficiency in pregnancy has been associated with unfavourable perinatal outcomes. However there are doubts if magnesium supplementation during pregnancy can previne preeclampsia especially in population with high nutritional risk. This trial aims to verify the effect of oral magnesium supplmentation on preeclampsia incidence in low income pregnant women.MethodsThis randomized, double-blind, placebo-controlled trial investigated the effect of oral magnesium citrate supplementation for preeclampsia in low-income Brazilian pregnant women, i.e. annual per capita income of US$ 1025 or less. Participants were admitted to the study with gestational age between 12 and 20 weeks. Magnesium serum level was measured pre-randomization and participants with hypermagnesemia were excluded. After randomizationg participants received magnesium citrate capsule (300 mg magnesium citrate) or a daily placebo capsule, until delivery. Intent-to-treat analysis was performed.ResultsA total of 416 pregnant women were screened and 318 enrolled according to the inclusion criteria; 159 for each arm. Twenty-eight pregnant women were lost to follow-up. 55/290 (18.9%) of pregnant women developed preeclampsia; 26/143 (18.1%) in magnesium group and 29/147 (19.7%) in the control group; OR 0.90 (CI 95% 0.48–1.69), p = 0.747. No cases of eclampsia were registered.ConclusionOral magnesium supplementation did not reduce preeclampsia incidence in low-income and low-risk pregnant women.Trial registrationRegistered at ClinicalTrials.gov (Identifier NCT02032186), December 19, 2013.
Highlights
Preeclampsia is the major cause of maternal morbidity and mortality in developing countries
A systematic review concluded that a higher total energy and lower magnesium and calcium intake measured during pregnancy were associated with hypertension related to pregnancy [12]
A randomized controlled trial found no difference in preeclampsia incidence between 185 pregnant women with Magnesium aspartate and 189 with placebo [17]. Based on all this we developed a large well-designed doubleblind randomized trial to verify the effect of oral magnesium supplmentation on preeclampsia incidence in low income pregnant women
Summary
Preeclampsia is the major cause of maternal morbidity and mortality in developing countries. There are doubts if magnesium supplementation during pregnancy can previne preeclampsia especially in population with high nutritional risk. This trial aims to verify the effect of oral magnesium supplmentation on preeclampsia incidence in low income pregnant women. Eclampsia is the major cause of maternal morbidity and mortality, especially in undeveloped and developing countries and represents one of the principal reasons for admission to intensive care units [2, 4]. A systematic review concluded that a higher total energy and lower magnesium and calcium intake measured during pregnancy were associated with hypertension related to pregnancy [12]. This review was based on a limited number of studies
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