Congenital rickets associated with magnesium sulfate infusion for tocolysis

Lamm, Carin; Norton, Karen I.; Murphy, Ramon; Wilkins, Isabelle; Rabinowitz, Jack G.

doi:10.1016/s0022-3476(88)80586-9

Cited by 73 publications

(29 citation statements)

References 16 publications

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“…Reports of a small number of cases have associated the infusion of magnesium sulfate to prevent uterine contractions during the second trimester with impaired formation of fetal bones and hypoplasia of the dental enamel. 23,24 Maternal hypermagnesemia may also occur as a result of magnesium infusion in individuals with already impaired renal function. This in turn may cause depressed maternal respiratory and cardiac rates or decreased fetal heart rate activity.…”

Section: Discussionmentioning

confidence: 99%

Pica during pregnancy in low-income women born in Mexico

Simpson

Mull²,

Longley³

et al. 2000

Western Journal of Medicine

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ⅷ Objective To describe pica behavior (ingestion of nonfood items) in pregnant low-income Mexican-born women in Mexico and the United States. ⅷ Design A convenience sample of informants was interviewed with a questionnaire containing open-ended and closed-ended questions. ⅷ Setting A low-income community on the outskirts of Ensenada, Mexico, and clinics serving low-income people in southern California (Santa Ana, Bakersfield, and Los Angeles). ⅷ Participants Of a total of 225 Mexican-born women, 75 (33%) were interviewed in Ensenada, and 150 (67%) were interviewed in southern California. ⅷ Results The prevalence of pica during pregnancy was 44% (n = 33) in the Ensenada group and 31% (n = 46) in the southern California group. Those who reported pica behavior more commonly had a relative who also practiced pica. ⅷ Conclusion The high reported rate of pica in this sample indicates that pregnant Mexicanborn women should be screened for pica and educated about the potentially serious effects on the fetus and mother.BACKGROUND Pica-the ingestion of nonfood items-has aroused the curiosity of medical personnel since at least the 16th century. 1 Pica in children has been studied extensively, but pica during pregnancy remains understudied and underreported. Recent articles exploring the practice 1-4 have been contradictory and present little conclusive evidence about its cause and prevalence. Pica during pregnancy is a worldwide phenomenon, 5-8 but in the United States it has been studied largely in the South, with an occasional report from the Midwest. Although this behavior is known to occur in pregnant Latina immigrants in the Los Angeles area, 9 there are no detailed descriptions of the practice in Mexican-born women either in the United States or in Mexico.The prevalence of pica in pregnant women has been reported from as low as 0% to as high as 68% in the various groups studied. 10 In general, pica behavior is probably underreported because the ingestion of nonfood items may be seen as either shameful or merely unimportant and "normal." 4 Suggested risk factors also vary between studies. A meta-analysis of dirt-, clay-, and starch-eating women found that race was the major risk factor for pica during pregnancy: it was 4 times higher in black women than in white women. 3 A study by Edwards et al, 11 however, found no significant racial difference in the prevalence of pica in a rural obstetric population; instead, a childhood, family, and nonpregnant history of pica behavior played a role. The meta-analysis also indicated that rural women were twice as likely as urban residents to exhibit pica and that lower socioeconomic status, greater maternal age, impaired nutritional status, and a childhood or family history of pica were additional risk factors. 3

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Section: Discussionmentioning

confidence: 99%

Pica during pregnancy in low-income women born in Mexico

Simpson

Mull²,

Longley³

et al. 2000

Western Journal of Medicine

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“…9 The more severe skeletal abnormalities which include decreased bone density, widening of the metaphyseal plates with elongated radiolucent zone but intact temporary zone of calcification, beading of the costochondral junctions and thinning of the calvaria are seen more often in infants who are exposed to magnesium starting in the second trimester. 1 Increased duration of magnesium exposure as well as prematurity, multiplicity and prenatal complications such as gestational diabetes all have been shown to contribute to the severity of the bone disease.…”

Section: Discussionmentioning

confidence: 99%

“…1 Thereafter, Lamm 2 reported that two infants developed bone changes after prolonged exposure to magnesium in utero. Since these first reports, approximately 25 infants with bone changes following magnesium exposure in utero have been described.…”

Section: Introductionmentioning

confidence: 99%

“…Since these first reports, approximately 25 infants with bone changes following magnesium exposure in utero have been described. 1,[3][4][5][6] In those reports, the severity of osteopenia was correlated with prolonged exposure 5 intrauterine growth retardation, 6 and multiplicity of birth. 5 As magnesium crosses the placenta, perhaps competing for calcium transport or at cellular sites, skeletal abnormalities in infants are likely related to the effects of prolonged magnesium exposure on calcium homeostasis in utero.…”

Section: Introductionmentioning

confidence: 99%

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Skeletal demineralization and fractures caused by fetal magnesium toxicity

et al. 2006

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“…These problems can be quickly reversed with medicine. [20][21][22][23][24][25][26][27][28][29][30][31] Review of several studies regarding the effect of MgSO 4 on mother and newborn FDA also reviewed published epidemiologic studies. 20,22,24,25,27,28,30 One of these studies found a statistically significant increase in bone abnormalities in neonates with in-utero exposure to MgSO 4 for >7 days, compared to those exposed for <3 days.…”

Section: Mgso 4 In Eclampsiamentioning

confidence: 99%