Osteopenic effects of MgSO4 in multiple pregnancies.
OBJECTIVE
To describe the effects of prolonged maternal treatment with MgSO4 in infants who were products of multiple pregnancies.


METHODS
Case series of infants presenting with osteopenia secondary to MgSO4 administration for preterm labor.


RESULTS
Ten premature infants with hypermagnesemia (4.5+/-0.2 mg/dl), hypocalcemia (6.0 +/-0.3 mg/dl), and high serum alkaline phosphatase (574+/-96 U/l) underwent imaging studies that showed diffuse osteopenia of the long bones and probable rib fractures. All mothers had isolated premature labor, for which they were given MgSO4; (average dose 3.66+/-0.08 kg/ pregnancy over 10.0+/-0.5 weeks). On follow-up (to 9 months), all infants had complete or near complete resolution of the osteopenia.


CONCLUSIONS
Premature infants who are exposed to large doses of MgSO4, especially those of multiple pregnancies, have an increased risk of developing hypocalcemia, osteopenia, and fractures. Our findings indicate that these infants should be identified at birth and managed prospectively.
Kaplan
Walid
W
Department of Pediatric Endocrinology and Metabolism, Texas Children's Hospital, Houston, TX, USA.
Haymond
Morey W
MW
McKay
Siripoom
S
Karaviti
Lefkothea P
LP
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium / Q000097:blood / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008274:Magnesium / Q000097:blood; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011859:Radiography
D050071:Bone Density Conservation Agents; D008278:Magnesium Sulfate; D000469:Alkaline Phosphatase; D002117:Calcitriol; D008274:Magnesium; D002118:Calcium