a Department of Internal Medicine, Faculty of Medicine , Srinakharinwirot University , Ongkharak , Thailand.
b Department of Obstetrics and Gynecology, Faculty of Medicine , Srinakharinwirot University , Ongkharak , Thailand.
Ren Fail. 2018 Nov;40(1):99-106. doi: 10.1080/0886022X.2017.1422518.
Preeclampsia is a common medical complication in pregnancy. It has been reported to be associated with decreased serum magnesium levels. However, there has not been evidence demonstrating utilization of change in magnesium for prediction of preeclampsia. The purpose of this study was to develop magnesium fraction-based equations which took other significant clinical risk factors into consideration for prediction of preeclampsia.
We collected serum total and ionized magnesium ionized magnesium levels from 84 pregnant women diagnosed with preeclampsia after week 20 of pregnancy. The ionized magnesium fraction was then calculated by the percentage ratio of ionized and total magnesium level.
Sixty-four (76.19%) women had normal pregnancy and 20 (23.81%) developed preeclampsia. The ionized magnesium fraction was significantly lower in preeclampsia group (23.95 ± 4.7% vs. 26.28 ± 2.3%, p = .04). Additionally, lower ionized magnesium fraction (24.67%), teenage and elderly primigravida were significantly associated with preeclampsia (OR = 4.41, 95% CI: 1.46-13.40, OR = 5.47, 95% CI: 1.85-35.42 and OR = 11.11, 95% CI: 1.09-113.78, respectively). Consequently, we attempted to develop ionized magnesium fraction-based equations calculate risk scores for preeclampsia. The area of ROC for predictive accuracy of the model was 0.77 (p < .001) and ROC suggested that the score of 0.27 would be a threshold for screening preeclampsia with 70% sensitivity and 81% specificity.
Ionized magnesium fraction may have been appropriate for screening of preeclampsia. We suggested blood testing on total and ionized magnesium concentrations as well as calculation of ionized magnesium fraction in addition to routine antenatal care for better screening of the disease.
子痫前期是妊娠中常见的医学并发症。据报道，它与血清镁水平降低有关。然而，目前尚无证据表明镁的变化可用于预测子痫前期。本研究的目的是开发基于镁分数的方程，该方程考虑了其他重要的临床危险因素，用于预测子痫前期。
我们收集了 84 名在妊娠 20 周后被诊断为子痫前期的孕妇的血清总镁和离子化镁水平。然后通过离子化镁与总镁水平的百分比比值计算离子化镁分数。
64 名（76.19%）孕妇正常妊娠，20 名（23.81%）孕妇发生子痫前期。子痫前期组的离子化镁分数明显较低（23.95±4.7% vs. 26.28±2.3%，p=0.04）。此外，较低的离子化镁分数（24.67%）、青少年和高龄初产妇与子痫前期显著相关（OR=4.41，95%CI：1.46-13.40，OR=5.47，95%CI：1.85-35.42，OR=11.11，95%CI：1.09-113.78）。因此，我们试图开发基于离子化镁分数的方程来计算子痫前期的风险评分。该模型预测准确性的 ROC 曲线下面积为 0.77（p<0.001），ROC 表明，分数为 0.27 将是筛查子痫前期的阈值，具有 70%的敏感性和 81%的特异性。
离子化镁分数可能适合用于子痫前期的筛查。我们建议在常规产前保健的基础上，同时检测总镁和离子化镁浓度，并计算离子化镁分数，以更好地筛查该疾病。
