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Using Serum Levels of Calcium, Magnesium, and Calcium/Magnesium Ratio to Predict Preeclampsia | ||
| Al- Anbar Medical Journal | ||
| Volume 21, Issue 3, July 2025, Pages 145-150 PDF (1 M) | ||
| Document Type: Original articles | ||
| DOI: 10.33091/amj.2025.155805.2039 | ||
| Authors | ||
| Aseel Ghazi Rifat1; Taghreed S. Saeed Al-Rawi* 2 | ||
| 1Department of Obstetrics and Gynaecology, College of Medicine, University of Kirkuk, Kirkuk, Iraq | ||
| 2Department of Biochemistry, College of Medicine, University of Anbar, Anbar, Iraq | ||
| Abstract | ||
| Background: Preeclampsia (PE) is a systemic disorder of pregnancy that is associated with significant perinatal morbidity and mortality. Calcium (Ca) and magnesium (Mg) play a pivotal role in regulating the contractility and tone of the cardiac and vascular muscle fibers. Objectives: To assess the role of serum levels of Ca, Mg and Ca/Mg ratio as predictors of PE severity. Materials and methods: A prospective cohort study was conducted that included 200 pregnant women who attended three prenatal checkups at 11, 24, and 35 weeks of gestation. Serum Ca and Mg levels were measured at each visit. Results: At the 11th week, the mean serum Ca level, Mg level, and Ca/Mg ratio were 9.09 ± 0.60 mg/dl, 2.92 ± 0.72 mg/dl and 3.28 ± 0.76, respectively. At the 24th week, women with early PE had the lowest mean serum Ca (7.94 ± 0.64 mg/dl) as compared to those without the health problem (9.12 ± 0.60 mg/dl). At the 35th week, preeclamptic women had significantly reduced serum Ca, Mg, and Ca/Mg ratio compared to non-preeclamptic women. The lowest mean serum levels of Ca, Mg, and Ca/Mg ratio were found in severe compared to mild PE (P-value < 0.05). At the 11th week, the cutoff values of 8.18 mg/dl for serum Ca, 2.04 mg/dl for Mg, and 3.09 for Ca/Mg ratio were valuable for predicting the severity of PE at the 35th week of pregnancy with 100% sensitivity and a specificity of 87%, 91% and 81%, respectively. Conclusion: The serum Ca, Mg, and the Ca/Mg ratio, measured at the 11th week of gestation, were critical predictors of severe PE at the 35th week. | ||
| Keywords | ||
| Calcium; Magnesium; Ca/Mg Ratio; Severe Preeclampsia | ||
| References | ||
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[1] A. F. Wenas and H. Y. Al-Massawi, "Association between gestational hypertension and preeclampsia with spontaneous prelabor rupture of membrane," Medical Journal of Babylon, vol. 19(2), pp. 281-287, 2022.
[2] A. Ohkuchi, H. Suzuki, K. Matsubara, K. Watanabe, T. Saitou, H. Oda, et al., "Exponential increase of the gestational-age-specific incidence of preeclampsia onset (COPE study): a multicenter retrospective cohort study in women with maternal check-ups at< 20 weeks of gestation in Japan," Hypertension Research, vol. 45(11), pp. 1679-1689, 2022.
[3] R. Q. Fawzi and A. G. Rifat, "The evaluation of maternal serum glycodelin level as a marker for the presence and severity of preeclampsia," Medical Journal of Babylon, vol. 20(Supplement 1), pp. S95-S100, 2023.
[4] Y. Yang, I. Le Ray, J. Zhu, J. Zhang, J. Hua, and M. Reilly, "Preeclampsia prevalence, risk factors, and pregnancy outcomes in Sweden and China," JAMA Network Open, vol. 4(5), pp. e218401-e218401, 2021.
[5] T. C. Macedo, E. Montagna, C. M. Trevisan, V. Zaia, R. de Oliveira, C. P. Barbosa, et al., "Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969," European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 248, pp. 177-186, 2020.
[6] D. Fanni, C. Gerosa, V. Nurchi, M. Manchia, L. Saba, F. Coghe, et al., "The role of magnesium in pregnancy and in fetal programming of adult diseases," Biological trace element research, vol. 199, pp. 3647-3657, 2021.
[7] A. Alwahab, R. Mohammed, and I. G. Zainal, "Measurement of Protein Oxidation Levels in Serum of Women with Pregnancy Complications," Egyptian Journal of Chemistry, vol. 64(11), pp. 6449-6455, 2021.
[8] C. Oh, E. C. Keats, and Z. A. Bhutta, "Vitamin and mineral supplementation during pregnancy on maternal, birth, child health and development outcomes in low-and middle-income countries: a systematic review and meta-analysis," Nutrients, vol. 12(2), p. 491, 2020.
[9] N. A. Ahmed, H. Alzain, M. O. Khalid, A. Abdein, M. Eltigani, and K. Bakheit, "Evaluation of Serum Total Calcium, Mg, Na+ and K+ Levels in Sudanese Women with Preeclampsia in Shendi town, River Nile State, North Sudan," World Wide Journal of Multidisciplinary Research and Development, vol. 6(1), pp. 24-9, 2020.
[10] R. D. Gebreyohannes, A. Abdella, W. Ayele, and A. C. Eke, "Association of dietary calcium intake, total and ionized serum calcium levels with preeclampsia in Ethiopia," BMC pregnancy and childbirth, vol. 21, pp. 1-7, 2021.
[11] K. N. Abdulla and M. S. Ahmed, "The Effect of Oral Magnesium Supplements on Lipid Profile and Oxidative Stress in Adult Albino Female Rats," Medico-Legal Update, vol. 20(1), 2020.
[12] C. E. Okoror, E. J. Enabudoso, O. T. Okoror, and C. A. Okonkwo, "Serum calcium‐magnesium ratio in women with pre‐eclampsia at a tertiary hospital in Nigeria," International Journal of Gynecology & Obstetrics, vol. 149(3), pp. 354-358, 2020.
[13] N. Wadhwani, K. Dangat, K. Randhir, A. Poddar, P. Joshi, H. Pisal, et al., "Longitudinal assessment of calcium and magnesium levels in women with preeclampsia," Biological trace element research, vol. 201(7), pp. 3245-3255, 2023.
[14] D. V. Kanagal, A. Rajesh, K. Rao, U. H. Devi, H. Shetty, S. Kumari, et al., "Levels of serum calcium and magnesium in pre-eclamptic and normal pregnancy: A study from Coastal India," Journal of clinical and diagnostic research: JCDR, vol. 8(7), p. OC01, 2014.
[15] P. Chaurasia, P. Jadav, and J. Jasani, "Changes in serum calcium and serum magnesium level in preeclamptic vs normal pregnancy," pp. 511-513, 2012.
[16] F. Aslam, I. Hayat, F. A. Zakir, S. S. Haider, S. U. Nisa, and S. U. Nisa, "Comparative analysis of serum calcium and magnesium as a better predictor in cases of mild and severe pre-eclampsia," The Professional Medical Journal, vol. 27(08), pp. 1722-1727, 2020.
[17] G. N. A. Winarno, A. Pribadi, H. J. Maruli, E. D. Achmad, R. Anwar, J. C. Mose, et al., "Ratio of serum calcium to magnesium levels on pregnancy with and without preeclampsia," Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, vol. 27, pp. e932032-1, 2021.
[18] B. A. Majeed, S. K. Jasim, H. Al-Momen, and M. J. Hussein, "Iraqi women with preeclampsia: maternal and neonatal outcomes," Open Access Macedonian Journal of Medical Sciences, vol. 8(B), pp. 866-870, 2020.
[19] J. Nambiar and P. Patil, "SERUM CALCIUM, MAGNESIUM AND CALCIUM—MAGNESIUM RATIO IN WOMEN WITH PREECLAMPSIA: A PROSPECTIVE OBSERVATIONAL STUDY," Indian Obstetrics and Gynaecology, vol. 13(1), 2023.
[20] E. Owusu Darkwa, C. Antwi-Boasiako, R. Djagbletey, C. Owoo, S. Obed, and D. Sottie, "Serum magnesium and calcium in preeclampsia: a comparative study at the Korle-Bu Teaching Hospital, Ghana," Integrated blood pressure control, pp. 9-15, 2017.
[21] S. Jain, P. Sharma, S. Kulshreshtha, G. Mohan, and S. Singh, "The role of calcium, magnesium, and zinc in pre-eclampsia," Biological trace element research, vol. 133, pp. 162-170, 2010.
[22] J. Tuli, P. Chakraborty, M. Hoque, S. Sarkar, M. Rahman, S. Begum, et al., "Serum Calcium Level in Preeclamptic Patients of Bangladesh," Mymensingh Medical Journal: MMJ, vol. 28(2), pp. 429-433, 2019.
[23] H. L. Roy, S. Nargis, M. M. Rahman, M. S. Hossain, M. R. Amin, M. Majumder, et al., "Evaluation of serum calcium levels in pre-eclampsia," Medicine Today, vol. 30(2), pp. 57-60, 2018.
[24] A. Gabbay, T. Tzur, A. Y. Weintraub, I. Shoham-Vardi, R. Sergienko, and E. Sheiner, "Calcium level during the first trimester of pregnancy as a predictor of preeclampsia," Hypertension in Pregnancy, vol. 33(3), pp. 311-321, 2014.
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