The Magnesium Story in Pregnancy-Levels in Maternal and Cord Blood-Correlation with Pregnancy Outcome
Dr. Kanchan Kulhari,
Department of Pathology, Command Hospital Western Command, Panchkula, Haryana, India.
Introduction: Magnesium (Mg) is the second most abundant intracellular cation, and is vital for a multitude of cellular functions and enzymes. Derangement of Mg homeostasis often leads to various diseases such as, Diabetes Mellitus (DM) and Insulin Resistance (IR), hypertension, atherosclerosis and depression. In pregnancy particularly, hypomagnesaemia has been associated with preterm delivery and low birth weight.
Aim: To measure maternal and cord blood Mg levels at delivery to calculate the prevalence of hypomagnesaemia in pregnancy, and to correlate Mg levels with other maternal and foetal variables at birth.
Materials and Methods: This cross-sectional correlational study was conducted in a 1000- bedded tertiary care centre in Northern India, and consisted of 110 pregnant women admitted for delivery. Maternal and cord blood was obtained at birth and analysed for serum Mg levels. The normality of continuous data was assessed by the Shapiro-Wilk test. Pearsonâ€™s correlation analysis was used to determine the relationship between continuous variables. Comparison of means of different groups was done by using unpaired t-test. A p-value <0.05 was considered statistically significant.
Results: Participants were aged between 18 to 36 years (Mean=26.8; SD=3.25). Out of 110 participants, 44 (40%) were hypomagnesaemic with serum Mg ≤1.8 mg/dL. Mean maternal Mg level was 1.93Â±0.31 mg/dL. Mean cord blood Mg level was 2.19Â±0.28 mg/dL. Maternal Mg levels were positively correlated with the period of gestation (r-value=0.246, p-value <0.01) and birth weight (r-value=0.205, p-value <0.05). Negative correlation was observed between cord blood Mg and period of gestation (r-value= -0.240, p-value <0.05) and birth weight (r-value=-0.303, p-value <0.01). Among the studied population, 58 (52.73%) women were vegetarians, and they had higher Mg levels than non-vegetarians (t= 2.14, p-value<0.05).
Conclusion: Hypomagnesaemia was highly prevalent among pregnant women in our setting. Micronutrient deficiencies are a potential public health problem. Larger, trimester-specific studies for antenatal screening to elucidate Mg deficiency, and alongside an all-round patient educational approach emphasising Mg-rich diet or Mg supplementation, could be highly beneficial to pregnant women in India.