Matsuda Y, Maeda Y, Ito M, Sakamoto H, Masaoka N, Takada M, Sato K
Department of Obstetrics and Gynecology, Kagoshima City Hospital, Japan.
Gynecol Obstet Invest. 1997;44(2):82-8. doi: 10.1159/000291492.
It has been reported that neonatal bone abnormalities occur as a result of long-term intravenous magnesium administration (MgSO4) to pregnant women. The purpose of this retrospective study was to evaluate the frequency of such abnormalities and the clinical background of both mothers and neonates.
We reviewed maternal (114 cases) and neonatal (139 cases) charts from all pregnant women who received intravenous MgSO4 administration for preterm labor and preeclampsia between June 1, 1992, and May 31, 1994. All chest X-ray films were obtained within 48 h after birth and reviewed by a doctor who was unaware of the clinical data. Radiolucent transverse metaphyseal bands of the proximal humerus were considered as abnormal. The subjects were divided into affected (group 1 and 1a) and unaffected (group 2 and 2a) groups. Neonates born to pregnant women given no MgSO4 at the same period, were considered as control.
The total number of bone abnormalities in the offspring of mothers receiving MgSO4 amounted to 13 (11.4%). Group 1 consisted of 13 cases and group 2 of 101 cases. In the control group bone abnormalities were not observed (p < 0.05). Significant differences were found between groups 1 and 2 in the gestational ages at the start of MgSO4 administration and at delivery, and in the total duration of administration and doses of MgSO4. Also, cases of multiple pregnancy and pregnancy complicated with impaired glucose tolerance were more prevalent in group 1. According to the results obtained from 139 neonates, cases showing low Apgar and high magnesium score and those receiving respiratory support were more noticeable in group 1a (15 cases).
The gestational ages and the total doses of MgSO4 in pregnant women were the main factors related to the onset of neonatal bone abnormalities, but other factors also have a possible bearing on the condition. In addition, the cases with onset of bone abnormality seemed to be associated with symptoms attributable to hypermagnesemia of neonates.
据报道，孕妇长期静脉输注镁剂（硫酸镁）会导致新生儿骨骼异常。本回顾性研究的目的是评估此类异常的发生率以及母亲和新生儿的临床背景。
我们回顾了1992年6月1日至1994年5月31日期间因早产和先兆子痫接受静脉输注硫酸镁治疗的所有孕妇的母亲（114例）和新生儿（139例）病历。所有胸部X线片均在出生后48小时内获取，并由一名不了解临床数据的医生进行阅片。肱骨近端透亮的干骺端横带被视为异常。研究对象分为受累组（第1组和第1a组）和未受累组（第2组和第2a组）。同期未接受硫酸镁治疗的孕妇所生新生儿被视为对照组。
接受硫酸镁治疗的母亲的后代中骨骼异常总数为13例（11.4%）。第1组有13例，第2组有101例。对照组未观察到骨骼异常（p < 0.05）。第1组和第2组在开始输注硫酸镁时的孕周、分娩时的孕周、硫酸镁的总输注时长和剂量方面存在显著差异。此外，多胎妊娠和合并糖耐量受损的妊娠病例在第1组中更为常见。根据139例新生儿的结果，第1a组（15例）中阿氏评分低、镁评分高以及接受呼吸支持的病例更为明显。
孕妇的孕周和硫酸镁的总剂量是与新生儿骨骼异常发生相关的主要因素，但其他因素也可能与此情况有关。此外，骨骼异常发病的病例似乎与新生儿高镁血症所致症状有关。
