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无症状新生儿镁水平变化的相关因素:一项纵向分析。

Factors Associated With Changes in Magnesium Levels in Asymptomatic Neonates: A Longitudinal Analysis.

作者信息

Mehta Yogesh, Shitole Charudatta, Setia Maninder Singh

机构信息

Department of Pediatrics, Dr. L H Hiranandani Hospital, Mumbai, India.

Dr. L H Hiranandani Hospital, Mumbai, India.

出版信息

Iran J Pediatr. 2016 Feb;26(1):e2662. doi: 10.5812/ijp.2662. Epub 2016 Jan 30.

Abstract

BACKGROUND

Neonates and infants with hypomagnesemia present with seizures and psychomotor delay.

OBJECTIVES

The present study evaluated the changes in magnesium (Mg) levels and factors associated with these in the first three days of life.

MATERIALS AND METHODS

We monitored 50 clinically asymptomatic neonates; they were not given any magnesium supplements even if they had hypomagnesemia at baseline. The variables analysed were: serum Mg; gestational age; birth weight; length; and the ponderal index. We used random effects (RE) models for longitudinal analysis of these data.

RESULTS

The mean standard deviation (SD) gestational age was 36.3 (3.6) weeks and the mean (SD) weight was 2604.2 (754.4) grams. About 31% of the neonates had hypomagnesemia (< 1.6 mg/dL) on day one; however, all had normal magnesium levels by day three of life (P < 0.001). At birth, after adjusting for intrauterine growth retardation status (IUGR), serum Mg levels were lower by 0.0097 mg/dL (95% CI: -0.019 to -0.0003) per 100 grams increase in weight of the neonate. After adjusting for IUGR status, the mean increase in the serum Mg levels was 0.14 mg/dL (95% confidence intervals [CI]: 0.10 to 0.18) per day. The per-day increase in magnesium levels was significantly higher in low birth weight babies (0.10, 95% CI: 0.01 to 0.18) compared with normal birth weight babies.

CONCLUSIONS

Asymptomatic neonates may have a high prevalence of hypomagnesemia; however, the levels become normal without any magnesium supplementation. Even though regular monitoring of magnesium levels is useful, no supplements are required - particularly in clinically asymptomatic neonates.

摘要

背景

低镁血症的新生儿和婴儿会出现惊厥和精神运动发育迟缓。

目的

本研究评估了出生后前三天镁(Mg)水平的变化以及与之相关的因素。

材料与方法

我们监测了50例临床无症状的新生儿;即使他们在基线时存在低镁血症,也未给予任何镁补充剂。分析的变量包括:血清镁;胎龄;出生体重;身长;以及 ponderal 指数。我们使用随机效应(RE)模型对这些数据进行纵向分析。

结果

平均标准差(SD)胎龄为36.3(3.6)周,平均(SD)体重为2604.2(754.4)克。约31%的新生儿在出生第一天有低镁血症(<1.6mg/dL);然而,到出生后第三天所有新生儿的镁水平均正常(P<0.001)。出生时,在校正宫内生长迟缓状态(IUGR)后,新生儿体重每增加100克,血清镁水平降低0.0097mg/dL(95%CI:-0.019至-0.0003)。在校正IUGR状态后,血清镁水平每天平均升高0.14mg/dL(95%置信区间[CI]:0.10至0.18)。与正常出生体重的婴儿相比,低出生体重婴儿的镁水平每日升高幅度显著更高(0.10,95%CI:0.01至0.18)。

结论

无症状新生儿可能有较高的低镁血症患病率;然而,无需补充任何镁,其水平即可恢复正常。尽管定期监测镁水平是有用的,但无需补充镁剂——尤其是临床无症状的新生儿。

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本文引用的文献

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[Familial congenital hypomagnesemia revealed by neonatal convulsions].[新生儿惊厥所揭示的家族性先天性低镁血症]
Arch Pediatr. 2013 Nov;20(11):1212-1218. doi: 10.1016/j.arcped.2013.08.019. Epub 2013 Sep 30.
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Serum magnesium levels in the newborn and older child.新生儿和大龄儿童的血清镁水平。
Arch Dis Child. 1966 Aug;41(218):424-7. doi: 10.1136/adc.41.218.424.
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Gestational diabetes and its impact on the neonate.妊娠期糖尿病及其对新生儿的影响。
Neonatal Netw. 2001 Sep;20(6):17-23. doi: 10.1891/0730-0832.20.6.17.

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