Maternal magnesium sulphate exposure predicts neonatal magnesium blood concentrations

Tocolytic use of magnesium sulphate is associated with excess neonatal mortality and has been proposed to follow a dose-response relationship. This study aimed to define the correlation between maternal and neonatal magnesium blood concentrations. Magnesium blood concentrations were retrospectively obtained for mother-neonate pairs who were cared for at an Intermountain Healthcare facility from January 2009 to October 2011. Complete data were available for 231 mother-neonate pairs. Mean (±SD) maternal and neonatal magnesium concentrations were 5.43±1.69 and 2.98±0.94 mg/dL, respectively. Maternal and neonatal magnesium concentrations were highly correlated (p<0.001). In univariate analyses, residual unexplained variability was high (r2=0.19). However, further multivariate analyses revealed that caesarian section, severe pre-eclampsia and Apgar score at 5 min. were significantly associated with neonatal magnesium concentrations (p<0.05 for all). Maternal magnesium concentrations correlate with neonatal exposure. This finding suggests that maternal monitoring deserves further evaluation as a marker of foetal toxicity.