Serum magnesium levels in neonates born to mothers who received magnesium sulphate during labour at Kenyatta National Hospital
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Date
2009-11Author
Muviku, Virginia
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Background: Magnesium sulphate administered to the mother parenterally is transported
actively through the placenta to achieve equilibrium in fetal serum. It takes about 2 hrs
for the maternal and fetal plasma levels to reach equilibrium. Neonatal serum magnesium
concentration remains elevated for the first 72 hrs of life. Neonates whose mothers
receive magnesium sulphate during labour have been found to have high serum
magnesium levels, a lower Apgar score and respiratory depression.
Objectives: To determine the serum magnesium levels in neonates born of mothers who
received Magnesium sulphate at K.N.H during labour, to document the clinical effects, if
any, in the neonates and to relate the levels of serum magnesium to the observed clinical
signs in the neonates.
Methodology: This was a quasi-experimental study, conducted at Kenyatta National
Hospital New Born Unit and Post natal wards.
The study subjects were 49 neonates, matched for gestational age with 49 controls.
Neonates born of mothers with severe pre-eclampsia/Eclampsia who received magnesium
sulphate during labour were recruited as exposed study subjects .The controls were
neonates of mothers who had mild pre-eclampsia and so did not receive magnesium
sulphate. Sampling of consecutive neonates was done until the required sample size was
attained. Serum magnesium and calcium were measured on a semi-automated analyzer
(Humalyzer) using commercial reagents.
Data Analysis: A standard data collection form was used to collect all the data which
was analyzed using the SPSS version 12. Independent sample t-test was used to
determine whether the mean serum magnesium differed significantly in the magnesium
exposed and non-exposed neonates. P values below 0.05 were considered significant.
x
Results
There were 49 neonates in each arm of the study. The two groups were comparable in
terms of birth weight and gestational age. Neonates whose mothers received magnesium
sulphate were found to have higher serum magnesium levels than those whose mothers
did not, with mean serum magnesium levels of 2.22mmolll and 1.22mmolll respectively,
p=<O.OO1.All the 49 (100%) study subjects had magnesium levels >1.04 mmolll
compared to 22 (44.9%) controls .The study subjects were also more likely to have
depressed neonatal reflexes than the controls but the difference was not stastically
significant, P'=O.297.
The study subjects were found to have a lower Apgar score at both one and five minutes
when compared with the controls. The mean score at Iminute was 6.8 and 7.5 for study
subjects and controls respectively (p=0.019) while at 5 minutes it was 8.1 and 8.9,
respectively. p=0.010.
Conclusions
Neonates whose mothers received magnesium sulphate had higher than normal serum
magnesium levels and were also found to have lower Apgar scores than the controls.
Recommendations
Close monitoring of neonates whose mothers receive magnesium sulphate during labour
is recommended. Further research that will follow up the neonates for a longer period to
establish the pattern of morbidity and mortality and determine whether it is associated
with the serum magnesium levels III the neonates is recommended
Citation
Masters of Medicine in Paediatrics and Child Health, University of Nairobi, 2009Publisher
Universty of Nairobi