Comparative Study between Serum Calcium and Magnesium Levels in Pre-eclampsia Versus Normal Pregnancy

Abstract Background: Numerous clinical studies had clarified the alliance between preeclampsia and disturbances in maternal biochemical macronutrients, involving serum calcium (Ca+2) and magnesium (Mg+2). Up till now, there is an escalated concern in benefitting from nutritional approach in the preec-lampsia management with respect to calcium and magnesium supplementation. Aim of Study: To assess serum levels of calcium and magnesium in pregnant females who suffered from pre-eclampsia in comparison with normal pregnant ladies. Patients and Methods: This study was a case-control one that recruited 100 pregnant women (50 pregnant preeclampsia cases and 50 normal pregnant females) from obstetrics clinics of Damanhour General hospital, and El-Sayed Galal Hospital of Al-Azhar University after the 20th week of gestation during the period of research from February 2020 to December 2020 for estimation off serum calcium and magnesium. Results: The mean serum calcium level in the control group was 8.99±0.52mg/dl, and mean serum magnesium level was 2.21±0.3mg/dl. Both were higher than those in the patients group as the mean serum Ca+2 was 8.05±0.51mg/dl and mean serum Mg+2 level was 1.86±0.25mg/dl (p<0.001). Calcium had significantly higher diagnostic accuracy than magnesium to differentiate normotensive pregnant women from preec-lamptic pregnant women. ROC curve showed that the optimum cut off for calcium was 8.55 (mg/dL) with sensitivity of 80%, specificity of 84%, PPV of 83.3%, andNPV of 80.8%. Calcium had largest area under the curve (AUC=were 0.898; CI: (0.840- 0.956) (p<0.001), indicating its importance for predicting preeclampsia. While the cut off value of magnesium was less than 2.15 (mg/dL), the sensitivity was 88%, specificity was 60%; an area under the ROC curve (AUROC) 0.806 (95% CI: 0.721-0.891). In addition, ROC curve showed the optimum cutoff for serum calcium was 8.15 (mg/dL) for predicting adverse outcome of pregnancy with sensitivity 60.6%, specif-icity 86.6%; and an area under the ROC curve (AUROC) 0.792 (95% CI: 0.701-0.883). While the cut off value of serum magnesium was less than 1.945 (mg/dL), the sensitivity was 69.7%, specificity was 67.2%; an area under the ROC curve (AUROC) 0.726 (95% CI: 0.618-0.834).
Conclusion: Both serum calcium and serum magnesium in preeclamptic pregnant women were lesser in comparison to their healthy pregnant counterparts. These outcomes sup-ported the postulation that there is a cause-consequence liaison between hypocalcaemia and hypomagnesaemia as potential etiologic factors incriminated in of preeclampsia pathogenesis.