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Congenital rickets associated with magnesium sulfate infusion for tocolysis

C I Lamm1, K I Norton, R J Murphy

  • 1Department of Pediatrics, Mount Sinai School of Medicine, New York, NY.

The Journal of Pediatrics
|December 1, 1988
PubMed

Insights

Intravenous magnesium sulfate for tocolysis in pregnant mothers may cause bone abnormalities and hypocalcemia in newborns. Prolonged treatment, particularly in the second trimester, could suppress fetal parathyroid glands, leading to rickets-like symptoms.

Area of Science:

  • Neonatal Health
  • Pharmacology
  • Pediatric Radiology

Background:

  • Tocolysis is the inhibition of uterine contractions to prevent premature birth.
  • Magnesium sulfate is a commonly used medication for tocolysis.
  • The effects of maternal magnesium sulfate treatment on neonatal outcomes require further investigation.

Observation:

  • A retrospective review of five neonates born to mothers receiving intravenous magnesium sulfate for tocolysis was conducted.
  • Radiographic, clinical, and biochemical data were collected for each infant.
  • Abnormalities were assessed to determine potential adverse effects.

Findings:

  • Two neonates exhibited radiographic bony abnormalities, including rachitic changes and dental enamel hypoplasia in one infant.
  • Transient hypocalcemia was observed in two infants, one of whom also had bony abnormalities.
  • These findings suggest a potential link between maternal magnesium sulfate treatment and neonatal skeletal and calcium metabolism issues.

Implications:

  • Prolonged maternal magnesium sulfate infusion, especially when initiated during the second trimester, may lead to fetal parathyroid gland suppression.
  • This suppression could result in neonatal abnormalities resembling rickets.
  • Further research is warranted to elucidate the mechanisms and clinical significance of these findings.

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