Maternal magnesium sulphate exposure predicts neonatal magnesium blood concentrations

Basic Clin Pharmacol Toxicol. 2014 Apr;114(4):318-22. doi: 10.1111/bcpt.12166. Epub 2013 Dec 11.

Abstract

Tocolytic use of magnesium sulphate is associated with excess neonatal mortality and has been proposed to follow a dose-response relationship. This study aimed to define the correlation between maternal and neonatal magnesium blood concentrations. Magnesium blood concentrations were retrospectively obtained for mother-neonate pairs who were cared for at an Intermountain Healthcare facility from January 2009 to October 2011. Complete data were available for 231 mother-neonate pairs. Mean (±SD) maternal and neonatal magnesium concentrations were 5.43±1.69 and 2.98±0.94 mg/dL, respectively. Maternal and neonatal magnesium concentrations were highly correlated (p<0.001). In univariate analyses, residual unexplained variability was high (r2=0.19). However, further multivariate analyses revealed that caesarian section, severe pre-eclampsia and Apgar score at 5 min. were significantly associated with neonatal magnesium concentrations (p<0.05 for all). Maternal magnesium concentrations correlate with neonatal exposure. This finding suggests that maternal monitoring deserves further evaluation as a marker of foetal toxicity.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Intravenous
  • Adult
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Infant, Newborn
  • Linear Models
  • Magnesium Sulfate / administration & dosage*
  • Magnesium Sulfate / blood*
  • Maternal Exposure*
  • Multivariate Analysis
  • Pre-Eclampsia / prevention & control
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Exposure Delayed Effects / blood*
  • Retrospective Studies
  • Tocolytic Agents / administration & dosage
  • Tocolytic Agents / adverse effects
  • Tocolytic Agents / blood
  • Treatment Outcome
  • Young Adult

Substances

  • Tocolytic Agents
  • Magnesium Sulfate