Maternal Magnesium Research Articles

A comparative study between maternal serum magnesium levels in preterm and term labour

A comparative study between maternal serum magnesium levels in preterm and term labour

Neonatal hyperkalemia associated with maternal ritodrine: A retrospective study.

We recently reported on a late preterm infant born at 36 weeks' gestation with serious arrhythmia due to hyperkalemia associated with long-term maternal ritodrine administration. It is unknown whether ritodrine alone increases the risk of neonatal hyperkalemia in infants born at 34-36 weeks' gestation. This single-center, retrospective, cohort study enrolled late preterm infants (34-36 gestational weeks) born between 2004 and 2018. Cases with maternal magnesium sulfate use were not sufficient for statistical analysis and so were excluded from the study. Risk factors for the occurrence of hyperkalemia were determined based on clinical relevance and previous reports. In all, 212 late preterm infants with maternal ritodrine use and 400 infants without tocolysis were included in the study. Neonatal hyperkalemia occurred in 5.7% (12/212) in the ritodrine group and 1.8% (7/400) in the control group. The risk of neonatal hyperkalemia was significantly increased by maternal ritodrine administration with a crude odds ratio (OR) of 3.37 (95% confidence interval [CI]: 1.30-8.69; p < 0.01) and an adjusted OR of 3.71 (95% CI: 1.41-9.74; p < 0.01) on multivariable analysis. Long-term tocolysis (≥28 days) with ritodrine increased the risk of neonatal hyperkalemia with 9.3% (11/118) of infants developing hyperkalemia (adjusted OR 4.86; 95% CI: 1.59-14.83; p < 0.01). Neonatal hyperkalemia was not found within 2 weeks of ritodrine administration. This research suggests that late preterm infants born after long-term ritodrine administration are at risk of neonatal hyperkalemia and require special attention.

To find association of socio-demographic factors of pregnant women with hypomagnesaemia

Magnesium is the second most common intracellular cation which is essential in metabolic processes, protein synthesis, membrane integrity, nervous tissue conduction, neuromuscular excitability, muscle contraction. In obstetrics magnesium has an important role in maternal and foetal wellbeing. Limited data is available in our state to find hypomagnesaemia during pregnancy and its association with socio-demographic profile of the women so the present study was done to find association of socio-demographic factors of the pregnant women with hypomagnesaemia. Methods: This was a hospital based cross-sectional study. 100 women in their third trimester of pregnancy and were included in the study after obtaining written informed consent. After detail history and examination, serum magnesium was measured. And data were analyzed. Results: Risk of hypomagnesaemia was 1.3 times in women who are ≥ 25 years, 1.5 times in urban women,3 times in obese women and 3 to 4 times in pre-eclamptic women. No significant association between hypomagnesaemia and gravid and parity. Women with gestational age &lt;34 weeks are 2.7 times at risk of hypomagnesaemia. There was a weak positive correlation between gestational age and serum magnesium and a weak negative correlation between maternal serum magnesium and maternal age, systolic blood pressure and diastolic blood pressure. Conclusion: Magnesium should be measured in every pregnant women so that magnesium deficiency can be identified early and adequate measures and magnesium supplementation can be given to prevent untoward complications.

Comparison of maternal serum magnesium level in eclampsia, preeclampsia and normal pregnant women admitted to El-Shatby Maternity Hospital

Comparison of maternal serum magnesium level in eclampsia, preeclampsia and normal pregnant women admitted to El-Shatby Maternity Hospital

Antenatal magnesium sulphate and delayed passage of meconium: A multicentre study

IntroductionThe published evidence on the association between magnesium sulphate (MgSO4) and delayed passage of meconium (DPM) is contradictory. ObjectivesTo determine whether there is an association between the administration of MgSO4 to the mother and DPM in the neonate, and to analyse serum magnesium levels in neonates in relation to the cumulative dose of MgSO4 administered to the mother. Population and methodsRetrospective and prospective descriptive and analytical study conducted in patients delivered at or before 32 weeks of gestation in 2 tertiary care hospitals. Delayed passage of meconium was defined as failure to pass meconium within 48 h of birth and/or need for rectal stimulation on 2 or more occasions to pass stool and/or interval of at least 48 h between the first and second bowel movements. ResultsThe study included 283 patients (204 retrospectively and 79 prospectively), of who 152 (53.7%) experienced DPM. Delayed passage of meconium was not associated with antenatal MgSO4 administration, the cumulative maternal MgSO4 dose or neonatal serum magnesium levels.Older gestational age (OR, 0.8; confidence interval [CI], 0.69–0.93; P = 0.003) was an independent protective factor against DPM, while the need for advanced resuscitation (OR, 2.24; CI 1.04–4.86; P = 0.04) was a risk factor for DPM. ConclusionThe neonatal serum levels of magnesium reached with the doses of MgSO4 administered to mothers were not associated with DPM. Lower gestational age and the need for advanced resuscitation were predictors associated with an increased risk of DPM.

Sulfato de magnesio antenatal y eliminación tardía de meconio: Estudio multicéntrico

IntroductionThe published evidence on the association between magnesium sulphate (MgSO4) and delayed passage of meconium (DPM) is contradictory. ObjectivesTo determine whether there is an association between the administration of MgSO4 to the mother and DPM in the neonate, and to analyse serum magnesium levels in neonates in relation to the cumulative dose of MgSO4 administered to the mother. Population and methodsRetrospective and prospective descriptive and analytical study conducted in patients delivered at or before 32 weeks of gestation in 2 tertiary care hospitals.Delayed passage of meconium was defined as failure to pass meconium within 48 hours of birth and/or need for rectal stimulation on 2 or more occasions to pass stool and/or interval of at least 48 hours between the first and second bowel movements. ResultsThe study included 283 patients (204 retrospectively and 79 prospectively), of who 152 (53.7%) experienced DPM.Delayed passage of meconium was not associated with antenatal MgSO4 administration, the cumulative maternal MgSO4 dose or neonatal serum magnesium levels.Older gestational age (OR, 0.8; confidence interval [CI], 0.69–0.93; P = .003) was an independent protective factor against DPM, while the need for advanced resuscitation (OR, 2.24; CI 1.04–4.86; P = .04) was a risk factor for DPM. ConclusionThe neonatal serum levels of magnesium reached with the doses of MgSO4 administered to mothers were not associated with DPM. Lower gestational age and the need for advanced resuscitation were predictors associated with an increased risk of DPM.

Magnesium sulphate neuroprotection mechanism is placental mediated by inhibition of inflammation, apoptosis and oxidative stress

IntroductionMaternal inflammation may induce placental cytokine production resulting in fetal exposure, and development of neonatal neurologic injury. Maternal magnesium sulphate (MG) is used as neuroprotective in preventing white matter brain injury. We sought to determine whether maternal MG can prevent placental activation of inflammatory pathways associated with fetal injury. MethodsPregnant Sprague Dawley rats at gestational day 20 (E20) (n = 24) received injections of intraperitoneal lipopolysaccharide (LPS; 500 μg/kg) or saline (SAL) at time 0. Dams were randomized to treatment with subcutaneous saline or MG for 2 h prior to and 2 h following LPS/saline injections. Four hours following first injection rats were sacrificed. Placentas were collected from all treatment groups (LPS/SAL, LPS/MG, SAL/MG, SAL/SAL). Placental Caspase 3, NF-kB p65, neuronal nitric oxide synthase (phospho-nNos) interleukin (IL)-6 and tumor necrotic factor-α (TNF-α) protein levels were determined by western blot and compared. ResultsMaternal LPS at E20 significantly increased protein levels of placental caspase 3 (0.22 ± 0.01 vs. 0.12 ± 0.01 u), NFkB p65 (0.27 ± 0.01 vs. 0.10 ± 0.01 u), phospho-nNOS (0.20 ± 0.01 vs. 0.10 ± 0.01 u) as well as IL-6 and TNF-α compared to control. MG treatment to LPS dams significantly reduced all placental mediators to levels similar to SAL/SAL controls (p < 0.05). DiscussionMaternal inflammation-induced fetal brain injury may be mediated via placental activation of inflammation, oxidative stress, and apoptotic pathways. The prevention of preterm brain injury could possibly intervene also via inhibition of one or more of these putative pathways.

Maternal Serum Zinc, Copper, Magnesium, and Iron in Spontaneous Abortions.

Twenty five percent of pregnant women have some degree of vaginal bleeding during the first trimester, and about 50% of those pregnancies end in spontaneous abortion (SA) because the fetus is not developing typically. As studies have reported that inadequacies of trace metals such as Copper (Cu), Zinc (Zn), Magnesium (Mg) can predispose to various adverse pregnancy outcomes (PO); multiple micronutrient (MMN) supplementations are given without justifying their deficiency and toxicities on the fetus. Earlier studies on effects of MMN supplementations during pregnancy have not considered the need, duration, dose, and time of initiation of supplementations leading to inconclusive results. So, there is a need to optimize this to prevent their abuse and side effects. This study can help in establishing critical cut-offs of these minerals in maternal serum that can forecast future pregnancy outcomes. Study measured the serum Zn, Cu, Mg, and Fe in pregnant women who presented with (n = 80) and without (n = 100) SA at 5-2weeks of pregnancy using iron -ferrozine method, magnesium-calmagite method, zinc reaction with nitro-PAPS, copper reaction with Di-Br- PAESA methods, respectively. Data analyzed using the student t test and cutoff value was established using Receiver Operating Characteristic (ROC) by SPSS software. Maternal serum Cu, Mg, Fe, and Zn levels measured were significantly lower in SA as compared to that of controls (p < 0.005) (Fig.1) and maternal age and Body mass index were not statistically significant different among study group. Maternal serum Cu, Mg, Zn and Iron (Fe) measured in 5-12weeks of pregnancy has the potential to forecast future occurrence of SA. The study has been registered under "The Clinical Trials Registry- India (CTRI)," -REF/2020/01/030393.

Type 2 immune polarization is associated with cardiopulmonary disease in preterm infants.

Postnatal maturation of the immune system is poorly understood, as is its impact on illnesses afflicting term or preterm infants, such as bronchopulmonary dysplasia (BPD) and BPD-associated pulmonary hypertension. These are both cardiopulmonary inflammatory diseases that cause substantial mortality and morbidity with high treatment costs. Here, we characterized blood samples collected from 51 preterm infants longitudinally at five time points, 20 healthy term infants at birth and age 3 to 16 weeks, and 5 healthy adults. We observed strong associations between type 2 immune polarization in circulating CD3+CD4+ T cells and cardiopulmonary illness, with odds ratios up to 24. Maternal magnesium sulfate therapy, delayed hepatitis B vaccination, and increasing fetal, but not maternal, chorioamnionitis severity were associated with attenuated type 2 polarization. Blocking type 2 mediators such as interleukin-4 (IL-4), IL-5, IL-13, or signal transducer and activator of transcription 6 (STAT6) in murine neonatal cardiopulmonary disease in vivo prevented changes in cell type composition, increases in IL-1β and IL-13, and losses of pulmonary capillaries, but not gains in larger vessels. Thereby, type 2 blockade ameliorated lung inflammation, protected alveolar and vascular integrity, and confirmed the pathological impact of type 2 cytokines and STAT6. In-depth flow cytometry and single-cell transcriptomics of mouse lungs further revealed complex associations between immune polarization and cardiopulmonary disease. Thus, this work advances knowledge on developmental immunology and its impact on early life disease and identifies multiple therapeutic approaches that may relieve inflammation-driven suffering in the youngest patients.

Preterm placental calcification: maternal calcium, magnesium, 25(OH)D levels and adverse obstetric outcomes in low-risk pregnant women

Aim: The aim of our study is to examine early and late preterm placental calcification (PPC) and compare their relationship with maternal calcium, magnesium and 25(OH) D levels and adverse obstetric outcomes.&#x0D; Material and Method: This prospective cohort study was conducted by examining the pregnant women at their 24th to 36th gestational weeks who applied to the Gynecology Department of Okmeydani Training and Research Hospital. In this study, 207 patients were selected as the study group. &#x0D; Results: When the early and late PPC groups were compared, rates of low birth weight (LBW) was statistically higher in the early PPC group. (p=0.022) Oligohydramnios was more common in the early and late PPC patients compared to non-PPC pregnant women. However, oligohydramnios and LBW were not found statistically significant difference in logistic regression analysis. There was also no statistically significant difference in maternal calcium, magnesium and vitamin D levels between the groups. &#x0D; Conclusion: Preterm placental calcifications might be associated with fetal and maternal complications. But the diagnosis of PPC alone is not effective in determining fetal prognosis.

Differences Post Delivery of Term Pregnancy Mean Maternal Serum Magnesium Level with Low Versus Normal Birth Weight

Background. Impaired fetal growth is still a major problem in obstetrics. Birth weight is usually used as an indicator of the well-being of the newborn and as an indirect measure of intrauterine nutrition during pregnancy and the mother's nutritional status during pregnancy. Magnesium contribute as a cofactor for various enzymes in the human body for metabolic processes. Fetal magnesium is obtained from maternal by transport through the placenta. In conditions of low magnesium levels will affect the epigenetic process, HPA-axis and GH-IGF axis of the fetus which in turn will result in fetal growth disorders. This study aims to determine the differences postdelivery serum magnesium levels of women at term pregnancy who give birth with low vs normal birth weight.&#x0D; Methods. This study used an observational analytic method with a cross sectional approach. Conducted from April 2020-December 2020 at Dr. M. Djamil Padang Central General Hospital and Network Hospital Faculty of Medicine, Andalas University. Total of 44 samples were divided into 2 groups, women who gave birth with low and normal birth weight babies. Samples was carried out at the Pramitha Padang Private Clinical Laboratory.&#x0D; Results: The mean maternal serum magnesium level in low birth weight group was 1.97 ± 0.16 mg/dL lower than normal birth weight group was 2.06 ± 0.14 mg/dL. Statistic test using the independent sample T test showed no differences in both groups (p = 0.064).&#x0D; Conclusion. The mean maternal serum magnesium level in low birth weight 1.97±0.16 mg/dL. The mean maternal serum magnesium level in normal birth weight was 2.06 ± 0.14 mg/dL. There was no significant difference on both groups.

Relation of multimineral-vitamin D supplementation and the risk of preeclampsia

BackgroundThe objective of this study was to determine the favorable effects of multimineral-vitamin D supplementation on pregnancy outcomes among women at risk for preeclampsia.Patients and methodsThis randomized double-blind controlled clinical trial was conducted among 46 women at risk for preeclampsia at 27 weeks of gestation, with positive roll-over test. Pregnant women were randomly assigned to receive either the multimineral-vitamin D supplements (n = 23) or the placebo (n = 23) for 9 weeks. Multimineral-vitamin D supplements were containing 800 mg calcium, 200 mg magnesium, 8 mg zinc, and 400 IU vitamin D3. Fasting blood samples were taken at baseline and after 9-week intervention to measure related factors. Newborns' outcomes were determined.ResultsAlthough no significant difference was seen in newborns' weight and head circumference between the two groups, mean newborns' length (51.3 ± 1.7 vs. 50.3 ± 1.2 cm, P = 0.03) was significantly higher in multimineral-vitamin D group than that in the placebo group. Compared to the placebo, consumption of multimineral-vitamin D supplements resulted in increased levels of serum calcium (+0.19 vs. −0.08 mg/dl, P = 0.03), magnesium (+0.15 vs. −0.08 mg/dl, P = 0.03), zinc (+8.25 vs. −21.38 mg/dl, P = 0.001), and vitamin D (+3.79 vs. −1.37 ng/ml, P = 0.01). In addition, taking multimineral-vitamin D supplements favorably influenced systolic blood pressure (−1.08 vs. 6.08 mmHg, P = 0.001) and diastolic blood pressure (DBP) (−0.44 vs. 3.05 mmHg, P = 0.02).ConclusionsMultimineral-vitamin D supplementation for 9 weeks in pregnant women at risk for preeclampsia resulted in increased newborns' length; increased circulating levels of maternal serum calcium, magnesium, zinc, and vitamin D; and led to decreased maternal systolic blood pressure and diastolic blood pressure.

Relationship between Maternal Serum Calcium and Magnesium Levels and Isolated Fetal Echogenic Intracardiac Focus Encountered During Second-trimester Ultrasound Screening

Relationship between Maternal Serum Calcium and Magnesium Levels and Isolated Fetal Echogenic Intracardiac Focus Encountered During Second-trimester Ultrasound Screening

Efficacy of Maternal Magnesium Sulfate Administration on the Neurodevelopmental Outcome of Preterm Babies: A Randomised Controlled Trial

Introduction: Cerebral Palsy (CP) is a disability which shows an increased incidence with prematurity and Low Birth Weight (LBW). Many studies suggest that Magnesium Sulfate (MgSO4 ) given to mothers expected to deliver preterm improves their neurodevelopmental outcome. Aim: To assess the role of administration of MgSO4 in improving neurodevelopmental outcome in preterm babies. Materials and Methods: This was a hospital-based, prospective interventional study open label, randomised controlled trial conducted from December 2015 to May 2016 in the Department of Neonatology at Jubilee Mission Medical College in Central Kerala, India. Randomisation was done in deliveries expected to occur at or below 34 weeks. The mothers were then divided into two groups, those who would receive either MgSO4 or a placebo (normal saline). A total of 83 babies were compared for their baseline characteristics, and the association of MgSO4 administration on neonatal mortality, and on Amiel-Tison angle abnormalities and developmental delay at six months was studied. Either Chi-square test or Fisher’s exact test was used to compare the percentages. Microsoft excel was used to enter data. IBM Statistical Package for the Social Science (SPSS) version 21.0 was used for analysis. Statistical significance was considered for p-value &lt;0.05. Results: Both groups were comparable on baseline characteristics. MgSO4 use in mothers was not significantly associated with reduction in neonatal mortality (p-value=0.205). At six months of age, use of MgSO4 was associated with significant reduction in Amiel-Tison angle abnormalities (p-value &lt;0.001), and reduction in developmental delay as assessed by Trivandrum development Screening Chart (p-value &lt;0.001), showing that MgSO4 has a neuroprotective role. Conclusion: Although the percentage of neonatal deaths in the MgSO4 group were less, it was not statistically significant. AmielTison angle abnormalities were significantly less in the group which received MgSO4 . Neurodevelopmental outcome as assessed by TDSC was also significantly less in the group which received MgSO4 . This suggests that antenatal MgSO4 protects preterm babies from cerebral palsy and neurodevelopmental disabilities. A larger study with a longer follow-up is suggested to confirm these findings.

Effects of maternal magnesium sulfate treatment on newborns.

Antenatal magnesium sulfate (MgSO4 ) has been used with mothers, but the influence of MgSO4 on the fetus is unclear. The purpose of this study is to determine whether longer antenatal MgSO4 exposure correlates with adverse effects in newborns. The clinical data of 77 infants born to mothers treated with MgSO4 were collected. The infants were divided into two groups according to (1) the serum Mg concentration, (2) cumulative Mg dose, and (3) duration of antenatal maternal Mg treatment, respectively. The serum Mg level of the infants correlated with that of the mothers but not with the duration of Mg treatment or the cumulative dose of Mg. There were no significant differences in the infants' clinical variables according to either the duration of Mg treatment or the cumulative dose of Mg. By contrast, enteral feeding tolerance began at a significantly later age and the heart rate on admission was significantly lower in infants with a serum Mg level ≥4.0 mmol/L than in those with a serum Mg level <4.0 mmol/L. Modest effects on the clinical variables of infants with higher serum Mg levels were determined, whereas neither the duration of Mg treatment nor the cumulative Mg dose correlated with the clinical variables of the infants. Thus, in newborns with only moderately elevated serum Mg levels, serious adverse effects are unlikely.

Prospective Associations of Early Pregnancy Metal Mixtures with Mitochondria DNA Copy Number and Telomere Length in Maternal and Cord Blood.

Background:Metal exposure during pregnancy influences maternal and child health. Oxidative stress and inflammation may mediate adverse effects of heavy metals, whereas essential metals may act as antioxidants. Mitochondrial DNA is a prime target for metal-induced oxidative damage. Telomere dysfunction is attributed to imbalances between reactive oxidant species and antioxidants.Objectives:We evaluated individual and joint associations of prenatal metals with mitochondrial DNA copy number (mtDNAcn) and telomere length (TL) in maternal and cord blood as biomarkers of inflammation and oxidative stress.Methods:We measured six nonessential metals (arsenic, barium, cadmium, cesium, lead, mercury) and four essential metals (magnesium, manganese, selenium, zinc) in first-trimester maternal red blood cells in Project Viva, a U.S. prebirth cohort. We measured relative mtDNAcn () and TL () in second-trimester maternal blood and mtDNAcn () and TL () in cord blood. We used multivariable linear regression and quantile g-computation to estimate associations between prenatal metals and the biomarkers. We used generalized additive models and Bayesian kernel machine regression to examine nonlinearity and interactions.Results:A 2-fold increase in maternal magnesium was associated with lower maternal [, 95% confidence interval (CI): , ] and cord blood (, 95% CI: , ) mtDNAcn. Lead was associated with higher maternal mtDNAcn (, 95% CI: 0.01, 0.06). Selenium was associated with longer cord blood TL (, 95% CI: 0.01 0.50). An association was observed between the nonessential metal mixture and higher maternal mtDNAcn (, 95% CI: 0.01, 0.07). There was a nonlinear relationship between cord blood mtDNAcn and magnesium; maternal mtDNAcn and barium, lead, and mercury; and maternal TL and barium.Discussion:Maternal exposure to metals such as lead, magnesium, and selenium was associated with mtDNAcn and TL in maternal second trimester and cord blood. Future work will evaluate whether these biomarkers are associated with child health. https://doi.org/10.1289/EHP9294

Higher maternal parathyroid hormone concentration at delivery is not associated with smaller newborn size.

Intrauterine growth restriction (IUGR) reflects inadequate growth in-utero and is prevalent in low resource settings. This study aimed to assess the association of maternal delivery parathyroid hormone (PTH) – a regulator of bone turnover and calcium homeostasis – with newborn anthropometry, to identify regulators of PTH, and to delineate pathways by which maternal PTH regulates birth size using path analysis. This was a cross-sectional analysis of data from participants (n = 537) enrolled in the Maternal Vitamin D for Infant Growth trial in Dhaka, Bangladesh. Primary exposures were maternal delivery intact PTH (iPTH) or whole PTH (wPTH) and outcomes were gestational age- and sex-standardized z-scores for birth length (LAZ), weight (WAZ), and head circumference (HCAZ). Hypothesized regulators of PTH included calcium and protein intake, vitamin D, magnesium, fibroblast-like growth factor-23 (FGF23), and C-reactive protein. Maternal iPTH was not associated with birth size in linear regression analyses; however, in path analysis models, every SD increase in log(iPTH) was associated with 0.08SD (95% CI: 0.002, 0.162) higher LAZ. In linear regression and path analysis models, wPTH was positively associated with WAZ. Vitamin D suppressed PTH, while FGF23 was positively associated with PTH. In path analysis models, higher magnesium was negatively associated with LAZ; FGF23 was positively associated and protein intake was negatively associated with LAZ, WAZ, and HCAZ. Higher maternal PTH in late pregnancy is unlikely to contribute to IUGR. Future studies should investigate maternal FGF23, magnesium and protein intake as regulators of fetal growth, particularly in settings where food insecurity and IUGR are public health problems.

Maternal metal intake during pregnancy and childhood behavioral problems in Japan: the Kyushu Okinawa Maternal and Child Health Study

ABSTRACT Objectives Lower maternal metal intake during pregnancy might affect childhood development. The current prebirth cohort study investigated the relationship between maternal intake of zinc, magnesium, iron, copper, and manganese during pregnancy and behavioral problems in Japanese children aged five years. Methods Subjects were 1199 mother–child pairs. Dietary intake during the preceding month was assessed using a diet history questionnaire. Emotional, conduct, hyperactivity, and peer problems and low prosocial behavior were assessed using the Strengths and Difficulties Questionnaire. Maternal age, gestation at baseline, region of residence, number of children, maternal and paternal education, household income, maternal depressive symptoms during pregnancy, maternal alcohol intake during pregnancy, maternal smoking during pregnancy, child’s birth weight, child’s sex, breastfeeding duration, smoking in the household during the first year of life, and some dietary confounders that were associated with outcomes under study in this population were adjusted for. Results Compared with maternal magnesium intake during pregnancy in the first quartile, magnesium intake in the second, third, and fourth quartiles was independently inversely related to childhood hyperactivity problems, but not to emotional, conduct, or peer problems or low prosocial behavior: the adjusted odds ratio between extreme quartiles was 0.48 (95% confidence interval: 0.23−0.99, P for trend = 0.04). No evident associations were observed between maternal intake of zinc, iron, copper, or manganese during pregnancy and childhood emotional, conduct, hyperactivity, or peer problems or low prosocial behavior. Conclusions The present study suggests that higher maternal magnesium intake during pregnancy is inversely associated with hyperactivity problems in Japanese children.

The Role of Afamin and Other Trace Elements in the Prediction of GDM: a Tertiary Center Experience.

The objective of this study was to evaluate the utility of first trimester maternal serum afamin levels together with vitamin E and various elements (zinc, copper, selenium, and magnesium) for the prediction of gestational diabetes mellitus (GDM). All pregnant women between 11th and 14th weeks of gestation admitted for combined test were asked to participate in the study. A total of 797 women gave permission to participate in the study between January and September 2019. Serum was obtained by centrifugation and samples were frozen and kept at - 80 °C. For final analysis, forty-three GDM patients and forty-four healthy controls were selected. Levels of afamin, vitamin E, zinc, copper, selenium, and magnesium were compared between groups. The mean levels of afamin were found to be higher in women with GDM without statistical significance (63.69 ± 82.33 vs 44.25 ± 32.25 mg/L, p = 0.149). Vitamin E levels were found to be higher in women with GDM compared to controls without any statistical significance (5.04 ± 5.33 vs 4.47 ± 3.83 μg/mL, p = 0.568). While first trimester copper concentrations were higher among diabetic women (187.26 ± 34.78 vs 175.17 ± 30.40 μg/L, p = 0.088), this was not statistically significant. The other element levels (zinc, selenium, and magnesium) were found to be similar between the two groups (p = 0.624, p = 0.088, p = 0.254, p = 0.872, respectively). The results of our study demonstrated that mean levels of afamin, vitamin E, and copper were higher in women with GDM compared to controls. Additionally, first trimester maternal zinc, selenium, and magnesium levels were similar between diabetic and healthy pregnant women. However, more studies are needed to clarify the relationship between blood trace concentrations and GDM.

The effects of maternal body mass index and plurality on maternal and umbilical cord serum magnesium levels in preterm birth at less than 32 weeks of gestation.

ObjectiveTo evaluate the effects of maternal body mass index (BMI) and plurality on maternal and umbilical cord serum magnesium levels after antenatal magnesium sulfate treatment.MethodsThis was a retrospective cohort analysis of 135 women treated with antenatal magnesium sulfate at less than 32 weeks of gestation between January 2012 and June 2018. Subjects were stratified into groups according to maternal BMI (group I [18.5–22.9 kg/m2], group II [23.0–24.9 kg/m2], and group III [≥25.0 kg/m2]) and plurality (singleton and twin). Univariable and multivariable analyses were performed to compare the umbilical cord serum magnesium levels between the groups.ResultsMaternal serum magnesium levels were not significantly different between the maternal BMI groups and singleton and twin pregnancies. Umbilical cord serum magnesium levels were significantly different among the maternal BMI groups (3.3±1.2 mg/dL in group I, 3.3±1.2 mg/dL in group II, and 4.0±1.4 mg/dL in group III, P=0.003). The trend of increase in magnesium levels was statistically significant (P=0.001, Jonckheere-Terpstra test). Umbilical cord serum magnesium levels were not significantly different according to plurality. However, in the multivariable analysis, maternal BMI and plurality were not significantly associated with umbilical cord serum magnesium levels after adjusting for indication and total dose of magnesium sulfate treatment, gestational age at delivery, mode of delivery, neonatal sex, and birth weight.ConclusionMaternal BMI and plurality were not significantly associated with maternal or umbilical cord serum magnesium levels after exposure to antenatal magnesium sulfate treatment.