ESPE Abstracts

Introduction: Hypocalcaemia is a biochemical abnormality noted in neonates and considered a possible side effect of maternal MgSO4 administration. Suggested mechanism is MgSO4 treatment increase maternal hypermagnesemia, inhibiting maternal parathyroid hormone secretion leading to maternal and foetal/neonatal hypocalcaemia.

Objectives: This study is aimed to identify common risk factors, presentation, biochemical abnormalities, severity, and treatment given for the neonates with hypocalcaemia on the Neonatal Unit at Walsall Manor Hospital.

Specific objectives: To identify any correlation between maternal MgSO4 therapy and neonatal hypocalcaemia?

Methodology: Retrospective cohort study for neonates admitted to Neonatal /Transitional Care Unit in Walsall Manor Hospital over 6-month period from 01/01/2022 to 30/06/2022.

Inclusion criteria: Term and preterm weighing >1500 g: total calcium <2 mmol/L or ionized calcium < 1.1 mmol/L Very low birth weight weighing <1500 g: total calcium <1.75 mmol/L or ionized calcium <1 mmol/L.

Results: Total live births (TLB) were 1762, 195 admitted to NNU and 78 had biochemical evidence of hypocalcaemia. 96% (76) with hypocalcaemia was symptomatic, 74 had respiratory distress, 2 (4%) had seizures and none had ECG changes. 98% (76) of hypocalcaemia was early onset; late onset and persistent 1 each respectively; and 46 of early onset, settled spontaneously. Among TLB, 18 neonates were less that 34+6 weeks, 6 less than 30 weeks and 12 were 30+0 to 33+6 weeks.

Discussion, conclusion, and recommendation: 74 out of 76 with symptoms having respiratory distress; Hypocalcaemia could be incidental finding in blood gas analysis in neonates with respiratory distress. Mean ionized calcium for neonates whose mothers received MgSO4(1.03mmol/L) was higher than that of neonates whose mother’s did not receive MgSO4 (0.98mmol/L). Mean total calcium for neonates whose mothers received MgSO4 (2.29 mmol/L) was lower than that of neonates whose mother’s did not receive MgSO4 (2.53 mmol/L). P value is above 0.05 hence we reject the alternative hypothesis that maternal MgSO4 is correlated with neonatal hypocalcaemia and accept the null hypothesis that MgSO4 has no effect on neonatal calcium levels. The limitation is the small sample size, hence multicenter study is recommended.