有不良妊娠结局史妇女的血清镁

L. M. Nebyshynets, E. N. Grudnitskaya, S. L. Voskresensky, E. N. Volkovets
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摘要

目的研究有不良妊娠结局史的妇女的血清镁。74 名育龄妇女在自愿知情同意的前提下参与了一项前瞻性队列研究。主要组(n = 31)包括有不利妊娠结局史的非孕妇:早产、自然流产、习惯性流产、未发育妊娠。对比组(n = 43)包括有两次或两次以上紧急分娩史的非孕妇。在准备怀孕期间,所有妇女的血清镁含量都通过甲苯胺蓝比色法进行了测定。77.6%有流产产科负担史的妇女(主要群体)存在各种月经周期紊乱(FIGO,2018)。在分析受检妇女血清中的镁含量时发现,两组妇女所获得的指标均符合既定的血清镁含量正常值参考范围。与此同时,主要群体妇女血清中的平均镁含量明显偏低,更接近正常值范围的下限,而对比 群体则处于正常值范围的中间:研究中血清镁指数的最佳临界值为0.796毫摩尔/升,所提出的预后模型的敏感性和特异性分别为80.6%和81.4%。在孕前咨询阶段测定妇女血清中的镁含量尤为重要。尽管所有受检妇女的血清镁水平都在正常值范围内,但在病史中出现不良妊娠结局的妇女中,血清镁水平明显较低,因此有必要在计划怀孕阶段为这类患者开具含镁药物。为了在血清镁值≤0.796毫摩尔/升的孕前准备框架内预防流产,建议摄入有机镁盐。
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Serum magnesium in women with a history of adverse pregnancy outcomes
Aim. To study of serum magnesium in women with a history of adverse pregnancy outcomes.Materials and Methods. 74 women of child-bearing age, subject to voluntary informed consent, participated in a prospective cohort study. The main group (n = 31) included non-pregnant women who had a history of unfavorable gestation outcomes: premature birth, spontaneous miscarriage, habitual miscarriage, undeveloped pregnancy. The comparison group (n = 43) consisted of non-pregnant women with a history of two or more urgent deliveries. In all women, in preparation for pregnancy, the content of serum magnesium was determined by colorimetric method with xylidine blue.Results. 77.6% of women with a burdened obstetric history of miscarriage (the main group) had various menstrual cycle disorders (FIGO, 2018). When analyzing the levels of magnesium in the blood serum of the examined women, it turned out that the obtained indicators in women of both groups corresponded to the established reference range of normal values of serum magnesium levels. At the same time, in the women of the main group, the average magnesium content in the blood serum was significantly lower and was closer to the lower limit of the range of normal values, and in the comparison group – in the middle of the range of normal values: 0.719 (0.672-0.767) mmol/l and 0.844 (0.778-0.922) mmol/l, respectively, p<0.001.The optimal threshold value of the serum magnesium index in the study was 0.796 mmol/l with the sensitivity and specificity of the proposed prognostic model of 80.6% and 81.4%, respectively.Conclusion. Determination of the level of magnesium in the blood serum of women at the stage of pre-pregnancy counseling is of particular importance. Despite the fact that all the examined women had serum magnesium levels within the range of its normal values, significantly lower serum magnesium levels were found in women with adverse pregnancy outcomes in the anamnesis, which necessitates prescribing magnesium-containing medications to such patients at the stage of pregnancy planning. For the prevention of miscarriage within the framework of preconception preparation with serum magnesium values ≤0.796 mmol/l, the intake of organic magnesium salts is recommended.
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