Serum Calcium and Magnesium Levels in Normal Ghanaian Pregnant Women: A Comparative Cross-Sectional Study

Authors

  • Robert Djagbletey Department of Anaesthesia, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana
  • Ebenezer Owusu Darkwa Department of Anaesthesia, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana
  • Papa Kobina Gyekye deGraft-Johnson Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana
  • Daniel Akwanfo Yaw Sottie Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana
  • Raymond Essuman Department of Anaesthesia, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana
  • George Aryee Department of Anaesthesia, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana
  • Ernest Aniteye Department of Anaesthesia, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana

DOI:

https://doi.org/10.3889/oamjms.2018.352

Keywords:

Calcium, Magnesium, Albumin, Protein, Pregnancy

Abstract

BACKGROUND: Pregnancy is described as a normal physiologic state associated with various biochemical changes. Magnesium and calcium are essential macronutrients required for foetal growth. Complications associated with their deficiency during normal pregnancy include; low neonatal birth weight, pre-eclampsia, eclampsia and preterm labour. Changes in serum levels of magnesium and calcium in normal pregnancy have not been extensively studied among Ghanaian women.

AIM: To determine the variation in serum magnesium and calcium levels with gestational age in normal pregnancy in Ghanaian women.

METHODS: A hospital-based comparative cross-sectional study was conducted among 32 normal non-pregnant women (Group A) and 100 normal pregnant women (Group B) attending the clinic at the Korle-Bu Teaching hospital. The group B pregnant women were further divided into Group B1 (n = 33), Group B2 (n = 37) and Group B3 (n = 30) based on their pregnancy gestation as first, second and third trimester respectively. Blood samples were obtained from the antecubital vein of subjects and total serum calcium, magnesium, protein and albumin were estimated. Data obtained were analysed using SPSS for windows version 20. Analysis of variance (ANOVA) was employed to determine the statistical differences between the groups. A p-value of ≤ 0.05 was considered significant.

RESULTS: Mean serum total calcium and magnesium in first, second and third trimester normal pregnant women were 2.14 ± 0.16, 2.13 ± 0.44, 2.13 ± 0.35 mmol/L and 0.77 ± 0.11, 0.77 ± 0.16 and 0.76 ± 0.14 mmol/L respectively. Mean serum total calcium and magnesium levels in non-pregnant women were 2.20 ± 0.16 and 0.80 ± 0.10 mmol/L respectively. There was a statistically non-significant difference in serum total calcium and magnesium between non-pregnant and normal pregnant women, with p-values of 0.779 and 0.566 respectively. Mean total serum protein and albumin in first, second and third-trimester normal pregnant women were 68.42 ± 10.37, 70.46 ± 6.84, 66.70 ± 7.83 g/L and 39.92 ± 3.22, 40.75 ± 8.06, 38.26 ± 3.02 g/L respectively. Mean total serum protein and albumin in non-pregnant women were 73.13 ± 7.02 and 42.94 ± 3.03 g/L respectively. Mean total serum protein and albumin levels were lower in pregnant women as compared to non-pregnant women with the difference being significant in the third trimester (p-values of 0.012 and 0.002).

CONCLUSION: Total serum calcium and magnesium levels in normal pregnancy were non-significantly lower compared to non-pregnant women in Ghana. There was a reduction in total serum protein, and albumin levels during pregnancy with a significant reduction noticed during the third trimester compared to the non-pregnant state.

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References

Dutta DC. Textbook of Obstetrics,; New Central Book agency (P) Ltd., 2011; 81:7381-142.

Allen LH. Introduction (please, complete the reference).

Luke B. Nutritional influences on fetal growth. Clinical obstetrics and gynecology. 1994; 37(3):538-49. https://doi.org/10.1097/00003081-199409000-00007 PMid:7955642

King JC. Determinants of maternal zinc status during pregnancy–. The American journal of clinical nutrition. 2000; 71(5):1334S-43S. https://doi.org/10.1093/ajcn/71.5.1334s PMid:10799411

Scholl TO, Reilly T. Anemia, iron and pregnancy outcome. The Journal of nutrition. 2000; 130(2):443S-7S. https://doi.org/10.1093/jn/130.2.443S PMid:10721924

Brar HS, Rutherford SE. Classification of intrauterine growth retardation. In Seminars in perinatology. 1988; 12(1):2-10. PMid:3287628

Zilva JF, Pannall PR, Mayne PD. Clinical chemistry in diagnosis and treatment. London: Lloyd-Luke, 1975. PMid:15637929 PMCid:PMC475734

Beckett G, Walker S, Rae P. Peter Ashby Clinical biochemistry (Lecture notes), 2005.

Pitkin RM, Reynolds WA, Williams GA, Hargis GK. Calcium metabolism in normal pregnancy: a longitudinal study. American Journal of Obstetrics & Gynecology. 1979; 133(7):781-90. https://doi.org/10.1016/0002-9378(79)90115-7

Dahlman T, Sjöberg HE, Bucht E. Calcium homeostasis in normal pregnancy and puerperium: a longitudinal study. Acta obstetricia et gynecologica Scandinavica. 1994; 73(5):393-8. https://doi.org/10.3109/00016349409006250 PMid:8009970

Black AJ, Topping J, Durham B, Farquharson RG, Fraser WD. A detailed assessment of alterations in bone turnover, calcium homeostasis, and bone density in normal pregnancy. Journal of Bone and Mineral Research. 2000; 15(3):557-63. https://doi.org/10.1359/jbmr.2000.15.3.557 PMid:10750571

Naylor KE, Iqbal P, Fledelius C, Fraser RB, Eastell R. The effect of pregnancy on bone density and bone turnover. Journal of Bone and Mineral Research. 2000; 15(1):129-37. https://doi.org/10.1359/jbmr.2000.15.1.129 PMid:10646122

Bidlack WR. Interrelationships of food, nutrition, diet and health: the National Association of State Universities and Land Grant Colleges White Paper. Journal of the American College of Nutrition. 1996; 15(5):422-33. https://doi.org/10.1080/07315724.1996.10718620 PMid:8892167

Khastgir G, Studd JW, King H, Abdaila H, Jones J, Carter G, Alaghbandâ€Zadeh J. Changes in bone density and biochemical markers of bone turnover in pregnancyâ€associated osteoporosis. BJOG: An International Journal of Obstetrics & Gynaecology. 1996; 103(7):716-8. https://doi.org/10.1111/j.1471-0528.1996.tb09845.x

Pitkin RM, Gebhardt MP. Serum calcium concentrations in human pregnancy. American Journal of Obstetrics & Gynecology. 1977; 127(7):775-8. https://doi.org/10.1016/0002-9378(77)90256-3

Cunningham FG, Gant NF, Leveno KJ, Larry C. Williams obstetrics. The Journal of Midwifery & Women's Health. 2003; 48(5):369. https://doi.org/10.1016/S1526-9523(03)00291-5

Kovacs CS. Calcium and bone metabolism in pregnancy and lactation. The Journal of Clinical Endocrinology & Metabolism. 2001; 86(6):2344-8. PMid:11397820

Kahn DA, Koos BJ. Maternal physiology during pregnancy. Current Diagnosis and Treatment Obstetrics and Gynecology. 2007; 10:155.

Givens MH, Macy IG. The chemical composition of the human fetus. Journal of Biological Chemistry. 1933; 102:7-17.

Trotter M, Hixon BB. Sequential changes in weight, density, and percentage ash weight of human skeletons from an early fetal period through old age. The anatomical record. 1974; 179(1):1-8. https://doi.org/10.1002/ar.1091790102 PMid:4821360

Standley CA, Whitty JE, Mason BA, Cotton DB. Serum ionized magnesium levels in normal and preeclamptic gestation. Obstetrics & Gynecology. 1997; 89(1):24-7. https://doi.org/10.1016/S0029-7844(96)00380-8

Pedersen EB, Johannesen P, Kristensen S, Rasmussen AB, Emmertsen K, Møller J, Lauritsen JG, Wohlert M. Calcium, parathyroid hormone and calcitonin in normal pregnancy and preeclampsia. Gynecologic and obstetric investigation. 1984; 18(3):156-64. https://doi.org/10.1159/000299073 PMid:6489849

Shaikh MK, Devrajani BR, Soomro AA, Ali Shah SZ, Devrajani T, Das T. Hypomagnesemia in Patients with Diabetes mellitus. World Applied Sciences Journal. 2011; 12(10):1803-6.

Indumati V, Kodliwadmath MV, Sheela MK. The role of serum electrolytes in pregnancy induced hypertension. J Clin Diagnostic Res. 2011; 5(1):66-9.

Schouten LJ, Goldbohm RA, van den Brandt PA. Height, weight, weight change, and ovarian cancer risk in the Netherlands cohort study on diet and cancer. American journal of epidemiology. 2003; 157(5):424-33. https://doi.org/10.1093/aje/kwf224 PMid:12615607

Hantoushzadeh S, Jafarabadi M, Khazardoust S. Serum magnesium levels, muscle cramps, and preterm labor. International Journal of Gynecology & Obstetrics. 2007; 98(2):153-4. https://doi.org/10.1016/j.ijgo.2007.04.009 PMid:17574257

Takaya J, Yamato F, Kaneko K. Possible relationship between low birth weight and magnesium status: from the standpoint of "fetal origin" hypothesis. Magnesium research. 2006; 19(1):63-9.

PMid:16846102

Makrides M, Crosby DD, Bain E, Crowther CA. Magnesium supplementation in pregnancy. Cochrane Database of Systematic Reviews. 2014(4).

Newman RL. Serum electrolytes in pregnancy, parturition, and puerperium. Obstetrics & Gynecology. 1957; 10(1):51-5. PMid:13441219

Achari G, Mishra KC, Achari K, Ramkissun R, Upadhyay SN. Serum magnesium in women in the normal state and in certain conditions. Journal of the Indian Medical Association. 1961; 36:93-5. PMid:13681198

Mahendru AA, Everett TR, Wilkinson IB, Lees CC, McEniery CM. A longitudinal study of maternal cardiovascular function from preconception to the postpartum period. Journal of hypertension. 2014; 32(4):849-56. https://doi.org/10.1097/HJH.0000000000000090 PMid:24406777

Gilligan DM, Badar DM, Panza JA, Quyyumi AA, Cannon RO. Effects of estrogen replacement therapy on peripheral vasomotor function in postmenopausal women. American Journal of Cardiology. 1995; 75(4):264-8. https://doi.org/10.1016/0002-9149(95)80033-O

Grindheim G, Estensen ME, Langesaeter E, Rosseland LA, Toska K. Changes in blood pressure during healthy pregnancy: a longitudinal cohort study. Journal of hypertension. 2012; 30(2):342-50. https://doi.org/10.1097/HJH.0b013e32834f0b1c PMid:22179091

Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy. Circulation. 2014; 130(12):1003-8. https://doi.org/10.1161/CIRCULATIONAHA.114.009029 PMid:25223771

Penaz J, Voigt A, Teichmann W. Contribution to the continuous indirect blood pressure measurement. Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete. 1976; 31(24):1030-3. PMid:1020409

Nama V, Antonios TF, Onwude J, Manyonda IT. Mid-trimester blood pressure drop in normal pregnancy: myth or reality?. Journal of hypertension. 2011; 29(4):763-8. https://doi.org/10.1097/HJH.0b013e328342cb02 PMid:21178781

Gaillard R, Bakker R, Willemsen SP, Hofman A, Steegers EA, Jaddoe VW. Blood pressure tracking during pregnancy and the risk of gestational hypertensive disorders: the Generation R Study. European heart journal. 2011; 32(24):3088-97. https://doi.org/10.1093/eurheartj/ehr275 PMid:21821845

Olatunbosun DA, Adeniyi FA, Adadevoh BK. Serum calcium, phosphorus and magnesium levels in pregnant and nonâ€pregnant Nigerians. BJOG: An International Journal of Obstetrics & Gynaecology. 1975; 82(7):568-71. https://doi.org/10.1111/j.1471-0528.1975.tb00688.x

Hanna B. The role of calcium correction during normal pregnancy at third trimester in Mosul. Oman medical journal. 2009; 24(3):188. https://doi.org/10.5001/omj.2009.37

Sultana MS, Begum R, Akhter QS, Lovely NS, Akhter S, Islam MT. Serum calcium and phosphate level in normal pregnant women. Bangladesh Journal of Medical Science. 2012; 11(3):217-20. https://doi.org/10.3329/bjms.v11i3.11732

Oberst WF, Plass ED. The variations in serum calcium, protein, and inorganic phosphorus in early and late pregnancy, during parturition and the puerperium, and in non-pregnant women. The Journal of clinical investigation. 1932; 11(1):123-7. https://doi.org/10.1172/JCI100395 PMid:16694022 PMCid:PMC435802

Dominiczak MH. Tietz Textbook of Clinical Chemistry. By CA Burtis and ER Ashwood, editors. Clinical Chemistry and Laboratory Medicine. 1999; 37(11-12):1136.

Winkel P, Statland BE, Bokelund H. The effects of time of venipuncture on variation of serum constituents: Consideration of within-day and day-to-day changes in a group of healthy young men. American journal of clinical pathology. 1975; 64(4):433-47. https://doi.org/10.1093/ajcp/64.4.433 PMid:1239188

Arneson WL, Brickell JM. Clinical Chemistry: a laboratory perspective. FA Davis, 2007.

Walker BR, Colledge NR. Davidson's Principles and Practice of Medicine E-Book. Elsevier Health Sciences, 2013.

Harewood WJ, Gillin A, Hennessy A, Armitstead J, Horvath JS, Tiller DJ. The effects of the menstrual cycle, pregnancy and early lactation on haematology and plasma biochemistry in the baboon (Papio hamadryas). Journal of medical primatology. 2000; 29(6):415-20. https://doi.org/10.1111/j.1600-0684.2000.290606.x PMid:11168833

Arneson WL, Brickell JM. Clinical Chemistry: a laboratory perspective. FA Davis, 2007.

Lips PT, Chapuy MC, Dawson-Hughes B, Pols HA, Holick MF. An international comparison of serum 25-hydroxyvitamin D measurements. Osteoporosis International. 1999; 9(5):394-7. https://doi.org/10.1007/s001980050162 PMid:10550457

Sayre RM, Dowdy JC, Shepherd J, Sadig I, Bager A, Kollias N. Vitamin D production by natural and artificial sources. Orlando, Florida, Photo Medical Society Meeting; 1998; 3:1.

Mull JW, Bill AH. Variations in serum calcium and phosphorus during pregnancy: I. Normal variations. American Journal of Obstetrics & Gynecology. 1934; 27(4):510-7. https://doi.org/10.1016/S0002-9378(34)90732-8

Tavana Z, Hosseinmirzaei S. Comparison of maternal serum magnesium level in pre-eclampsia and normal pregnant women. Iranian Red Crescent Medical Journal. 2013; 15(12). https://doi.org/10.5812/ircmj.10394 PMid:24693379 PMCid:PMC3955494

Kanagal DV, Rajesh A, Rao K, Devi UH, Shetty H, Kumari S, Shetty PK. Levels of serum calcium and magnesium in pre-eclamptic and normal pregnancy: A study from Coastal India. Journal of clinical and diagnostic research: JCDR. 2014; 8(7):OC01. https://doi.org/10.7860/JCDR/2014/8872.4537

De Swiet M. The respiratory system, in Clinical physiology in obstetrics, G. Chamberlain and F. Broughton Pipkin, Editors. Blackwell Science Ltd: Oxford, 1998:111-128.

Susser M. Maternal weight gain, infant birth weight, and diet: causal sequences. The American journal of clinical nutrition. 1991; 53(6):1384-96. https://doi.org/10.1093/ajcn/53.6.1384 PMid:2035466

Published

2018-11-21

How to Cite

1.
Djagbletey R, Darkwa EO, deGraft-Johnson PKG, Sottie DAY, Essuman R, Aryee G, Aniteye E. Serum Calcium and Magnesium Levels in Normal Ghanaian Pregnant Women: A Comparative Cross-Sectional Study. Open Access Maced J Med Sci [Internet]. 2018 Nov. 21 [cited 2024 Mar. 28];6(11):2006-11. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.352

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Section

A - Basic Science

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