University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, Texas.
Obstet Gynecol. 2013 Feb;121(2 Pt 1):314-320. doi: 10.1097/AOG.0b013e31827d90cc.
To estimate the effect of body mass index (BMI) on magnesium levels for eclampsia prophylaxis.
This is a retrospective study from 2004 to 2011, examining magnesium levels in women receiving seizure prophylaxis. Women received 6 g and then 2 g/h. Women had 4-hour and 12-hour levels drawn. Levels were considered subtherapeutic at less than 4.9 mg/dL, therapeutic from 4.9 to 8.4 mg/dL, and supratherapeutic at 8.5 mg/dL or more. If the 4-hour value was not therapeutic, the dose was adjusted and a 12-hour level was drawn. Levels at 4 and 12 hours were compared among the women with different BMI classifications and clinical characteristics.
During the study period,106,265 women delivered, and 7,799 (7.4%) had preeclampsia diagnosed and received magnesium sulfate for seizure prophylaxis. A total of 5,304 (68%) of these women had a recorded BMI. At 4 hours, 2,698 (51%) were subtherapeutic. These women were more likely to be older, parous, undergo cesarean delivery, have a higher systolic blood pressure, and have central nervous system manifestations. At 12 hours, 2,342 (90%) of therapeutic women remained therapeutic, and 5% became subtherapeutic (n=118) or supratherapeutic (n=140). Using logistic regression, we were able to predict being subtherapeutic in women with greater BMI and to predict being supratherapeutic if women had labor longer than 12 hours and worsening severity of preeclampsia.
Women receiving seizure prophylaxis with a BMI of more than 30 may benefit from routine serum magnesium evaluation 4 hours after the loading dose.
III.
评估体重指数（BMI）对子痫前期预防镁水平的影响。
这是一项回顾性研究，时间为 2004 年至 2011 年，检查接受癫痫预防的女性的镁水平。女性接受 6 克，然后每 2 克/小时。女性有 4 小时和 12 小时的水平。水平低于 4.9mg/dL 被认为是治疗不足，4.9 至 8.4mg/dL 之间为治疗有效，8.5mg/dL 或更高为治疗过度。如果 4 小时的值不是治疗有效，则调整剂量并抽取 12 小时的水平。比较不同 BMI 分类和临床特征的女性之间的 4 小时和 12 小时的水平。
在研究期间，106265 名妇女分娩，7799 名（7.4%）被诊断为子痫前期并接受硫酸镁治疗癫痫预防。其中 5304 名（68%）女性有记录的 BMI。4 小时时，2698 名（51%）为治疗不足。这些女性更可能年龄较大、经产、行剖宫产、收缩压较高，并有中枢神经系统表现。12 小时时，2342 名（90%）治疗有效的女性仍然有效，5%（n=118）变为治疗不足或治疗过度（n=140）。使用逻辑回归，我们能够预测 BMI 较高的女性治疗不足，并且如果女性分娩时间超过 12 小时且子痫前期严重程度恶化，则预测治疗过度。
BMI 超过 30 的接受癫痫预防的女性可能受益于负荷剂量后 4 小时常规血清镁评估。
III。
