The study of association between maternal serum magnesium levels and preterm labour in a tertiary care hospital

Abstract

Background: Serum magnesium level in pregnancy is a valuable tool to find out preterm onset of labour. In the asymptomatic group, greater surveillance and administration of steroids, tocolytics and transfer to a higher centre wherever necessary has to be done with mothers with low serum magnesium level. The objective of the study is to find association between serum magnesium levels and women with preterm labour, and to compare these values with those patients who have a term delivery.Methods: The subjects included 100 pregnant women with preterm labour (cases) between 28 and 37 weeks gestation (Group A) and similar number of pregnant women with term labour (controls) between 37 and 40 weeks (Group B). Inclusion criteria for cases was singleton pregnancy, painful uterine contractions more than two in 30 minutes, intact fetal membranes, cervical dilatation (at least 1 cm) and effacement (80%). Serum magnesium levels were done in both the groups. Patients were followed until delivery. Routine antenatal investigations were done. Serum levels of magnesium were estimated by Erba’s semi auto-analyser.Results: 62% patients in Group A were from rural areas. More patients in Group A (70%) were from low socioeconomic class. More women in Group A were anaemic (44%). Mean value of hemoglobin in Group A was 9.93gm/dL. More patients in Group A had muscle cramps (89%). VLBW (<1500gm) neonates were more in Group A (21%). Also, LBW (1500-2499gm) neonates were more in Group A (60%). Mean neonatal birth weight in Group A (1907.3gm) was less. Neonatal morbidity and mortality was observed significantly more in Group A. Mean serum magnesium was less in Group A. Mean serum magnesium levels in primi and multigravida patients were less in Group A. Moreover, mean serum magnesium levels were less in urban and rural patients in Group A. Mean serum magnesium levels were less in normal and overweight patients in Group A. Also, mean serum magnesium levels were less in patients with cervical dilatation <3cm and >3cm in Group A.Conclusions: Low maternal serum magnesium level is associated with preterm labour. Patients with preterm labour have significantly low serum magnesium level when compared with labour at term.

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

“…In present studies 72.7% women with hypomagnesaemia were above 25 years with an odd ratio of 1.3 [0.4667 -3.8093]. Our results were in line with that of Anand S et al 17 . They observed that with increasing age there is significant decrease in serum magnesium levels (p=0.002).…”

“…The risk of hypomagnesaemia was 2.8 times in women with BMI ≥25 kg/m 2 . This was consistent with results that of Anand S et al 17 and Begum and Das 18 , who found that mean serum magnesium level was higher in women with BMI >25kg/m2 compared to BMI ≤25kg/m 2 .…”

“…It was observed that with increase in gravidity risk of hypomagnesaemia is 1.6 times increased though it was not significant [1.6(0.6026 -4.1116;p =0.3)]. Our results were consistent with results of Anand S et al where there was significant decrease in serum magnesium levels in gravida 2 and 3 as compared to gravid one 17 . Kumar correlated serum magnesium levels among pregnant women with increasing parity and found that pregnant women with parity 2 and more had lower serum magnesium level when compared to primigravida.…”

“…Risk of hypomagnesaemia was 1.5 times more in women residing in urban area as compared to women residing in rural areas [1.5 (0.5461 -4.0693; p-0.4)] in present study. Anand S et al in their study observed that serum magnesium was less in urban and rural women but it was significantly less in women of rural areas 17 . However, Kumar et al, in their study reported that serum magnesium levels showed slight decrease in both rural and urban pregnant women cases compared to controls but the difference was statistically not significant 19 .…”