INDICATORS OF MAGNESIUM LEVELS IN PREGNANT WOMEN WITH VOMITING OF VARIOUS SEVERITY LEVELS

INDICATORS OF MAGNESIUM LEVELS IN PREGNANT WOMEN
WITH VOMITING OF VARIOUS SEVERITY LEVELS

In today’s conditions, the frequency of vomiting in pregnant women is ob-
served in 60.0–80.0% of pregnancies, and the necessity for hospitalization and spe-
cial treatment arises in 12.0–17.8% of pregnant women. The symptoms of vomit-
ing in pregnant women usually appear from the fourth to ninth week of pregnancy,
reaching their peak at the seventh to twelfth week and subsiding by the sixteenth
week of pregnancy. The frequency of vomiting in pregnant women does not tend
to decrease and is encountered in 8.5–13.5% of pregnancies.
One of the main issues in the etiopathogenesis of vomiting in pregnant women
is the presence and severity of the imbalance of microelements and vitamins, which
is expected to result from nutritional inadequacy due to food aversion and losses
of microelements with vomiting, leading to increasing hemoconcentration. One of
the important microelement is magnesium (Mg). Mg is necessary for the biosyn-
thesis, transport, and activation of vitamin D, and it plays a role in its metabolism,
increasing the sensitivity of “target organs” to it. Mg plays a significant role in the
immune response as a cofactor for the synthesis of immunoglobulins and other
processes associated with the function of T and B cells.
The physiological daily requirement for Mg for adults is 500.0 mg/day, and
for pregnant and lactating women, an additional +50.0 mg/day is recommended.

However, the actual daily intake of Mg from food is half of what is required. Hy-
pomagnesemia is considered a decrease in the concentration of Mg in the blood
serum of less than 0.8–1.2 mmol/L. Assessment of magnesium status in patients
is carried out according to the International Expert Council on Mg Deficiency in
Obstetrics and Gynecology using questionnaires. Mg has an anti-stress activity: it
reduces the excitability of the nervous system, normalizes sleep, and calms, which
is an extremely important factor in the prevention and treatment of vomiting in
pregnant women. The aspect of the influence of Mg deficiency on the severity of
early gestational hypertension is insufficiently studied, which was the rationale for
conducting this study.

RESEARCH OBJECTIVE.
To characterize the magnesium status in pregnant women with vomiting of
different severity levels.

MATERIALS AND METHODS.
After obtaining written consent for comprehensive examination, 100 women
with vomiting between the ages of 18 and 40 (main group) were examined. Pa-
tients in the main group were divided according to the severity of vomiting during
pregnancy as follows: 41 women with mild, 37 women with moderate, and 22
women with severe vomiting. The control group consisted of 50 women of similar
age with a physiological course of the first trimester of pregnancy.
The assessment of Mg deficiency was carried out according to the adapted
standardized clinical scoring questionnaire (by P. Slagle, 2011), which is used in
international clinical practice. It is composed in accordance with the scale of signs
of Mg deficiency, which includes family and social factors, diet and eating habits,
symptoms of Mg deficiency, signs of connective tissue dysplasia, and physical ac-
tivity. Each sign was scored, and the sum was calculated. The assessment of Mg
deficiency was determined based on the score sum: 0-29 points – no Mg deficiency,
30–50 points – Mg insufficiency; 51 points and more – Mg deficiency.
Results and discussion. According to the survey results, magnesium deficiency
predominated in women in the main group, and only 17 (17.0%) pregnant wom-
en were found to have no magnesium deficiency, while in the control group, Mg
insufficiency was observed in 7 (14.0%), and Mg deficiency was observed in only
one (2%) case. The difference of results in the main group compared to the control
group was taken as reliable at p<0.05.
For a more detailed study of the occurrence of magnesium deficiency in the
presence of vomiting in pregnant women, an assessment of magnesium content in
patients of the main group was conducted depending on the severity of vomiting.

Results of assessing the questionnaire indicators for diagnosing magnesium defi-
ciency in pregnant women in the main group depending on the severity of vomit-
ing in pregnant women (n; %; p)
Mild Degree, 41 women, (n, %) Moderate Degree, 37 women, (n, %) Severe
Degree, 22 women, (n, %) p
0–29 (no magnesium deficiency) 10 (24.3%) 4 (10.8%) 3 (13.6%) p1,2,3<0.05
30–50 (magnesium insufficiency) 16 (39.1%) 9 (24.3%) 3 (13.6%) p1,2,3<0.05
≥ 51 (magnesium deficiency) 15 (36.3%) 24 (64.9%) 16 (72.8%) p1,2,3<0.05
p1 – the significance of differences between mild and moderate degrees
p2 – the significance of differences between mild and severe degrees
p3 – the significance of differences between moderate and severe degrees
Therefore, with an increase in the severity of vomiting in pregnant women, the
frequency of magnesium deficiency increases.
Analysis of the questionnaire used to determine magnesium deficiency revealed
a significant prevalence of magnesium deficiency.

Conclusion. In the majority of women with singleton uterine pregnancy at a ges-
tational age of 4–12 weeks and signs of vomiting, aged 18 to 40 years, there is an
insufficiency and deficiency of magnesium, and their frequency increases with the
severity of vomiting in pregnant women.