{"title":"Effects of antenatal magnesium sulfate administration on parathyroid hormone secretion in preterm infants.","authors":"Satomi Inomata, Yuko Wada, Kyota Sasamoto, Riko Kato, Mitsuhide Nagaoka, Yukako Kawasaki, Kentaro Tamura, Taketoshi Yoshida","doi":"10.1016/j.pedneo.2025.05.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Antenatal magnesium sulfate (MgSO<sub>4</sub>) administration has raised concerns regarding its potential impact on calcium metabolism in preterm infants. However, its effects on parathyroid hormone (PTH) secretion in infants remain unclear. This study aimed to evaluate the influence of antenatal MgSO<sub>4</sub> on parathyroid function in preterm infants.</p><p><strong>Methods: </strong>Preterm infants born at 28-33 weeks of gestation were divided into two groups: the Mg group (infants who received antenatal MgSO<sub>4</sub>, n = 41) and the non-Mg group (infants who did not receive antenatal MgSO<sub>4</sub>, n = 24). Neonatal blood samples, collected within 0.5-3 h after birth, were analyzed for serum calcium, phosphorus, magnesium, alkaline phosphatase, and whole PTH levels. Biochemical data were compared between the groups, and multivariate analysis was performed to assess antenatal MgSO<sub>4</sub> as an independent factor associated with lower whole PTH levels. The relationships between serum calcium and serum whole PTH levels were also analyzed in each group to evaluate MgSO<sub>4</sub>'s suppressive effect on parathyroid function during hypocalcemia.</p><p><strong>Results: </strong>Serum whole PTH levels were significantly lower in the Mg group (24.7 ± 20.1 pg/mL) than in the non-Mg group (56.2 ± 47.1 pg/mL, p = 0.002). Serum phosphorus, magnesium, and alkaline phosphatase levels were significantly elevated in the Mg group (p < 0.001 for all). Multivariate analysis confirmed that antenatal MgSO<sub>4</sub> was an independent factor associated with lower whole PTH levels, even after adjusting for gestational age, sex, and serum calcium levels (β = -0.44, p < 0.001). A significant inverse correlation between serum whole PTH and serum calcium levels was observed in the non-Mg group (ρ = -0.77, p < 0.001), but not in the Mg group.</p><p><strong>Conclusion: </strong>Antenatal MgSO<sub>4</sub> administration reduces PTH levels and suppresses the parathyroid response to hypocalcemia in preterm infants. Postnatal calcium homeostasis should be closely monitored in these infants.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatrics and Neonatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.pedneo.2025.05.008","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Antenatal magnesium sulfate (MgSO4) administration has raised concerns regarding its potential impact on calcium metabolism in preterm infants. However, its effects on parathyroid hormone (PTH) secretion in infants remain unclear. This study aimed to evaluate the influence of antenatal MgSO4 on parathyroid function in preterm infants.
Methods: Preterm infants born at 28-33 weeks of gestation were divided into two groups: the Mg group (infants who received antenatal MgSO4, n = 41) and the non-Mg group (infants who did not receive antenatal MgSO4, n = 24). Neonatal blood samples, collected within 0.5-3 h after birth, were analyzed for serum calcium, phosphorus, magnesium, alkaline phosphatase, and whole PTH levels. Biochemical data were compared between the groups, and multivariate analysis was performed to assess antenatal MgSO4 as an independent factor associated with lower whole PTH levels. The relationships between serum calcium and serum whole PTH levels were also analyzed in each group to evaluate MgSO4's suppressive effect on parathyroid function during hypocalcemia.
Results: Serum whole PTH levels were significantly lower in the Mg group (24.7 ± 20.1 pg/mL) than in the non-Mg group (56.2 ± 47.1 pg/mL, p = 0.002). Serum phosphorus, magnesium, and alkaline phosphatase levels were significantly elevated in the Mg group (p < 0.001 for all). Multivariate analysis confirmed that antenatal MgSO4 was an independent factor associated with lower whole PTH levels, even after adjusting for gestational age, sex, and serum calcium levels (β = -0.44, p < 0.001). A significant inverse correlation between serum whole PTH and serum calcium levels was observed in the non-Mg group (ρ = -0.77, p < 0.001), but not in the Mg group.
Conclusion: Antenatal MgSO4 administration reduces PTH levels and suppresses the parathyroid response to hypocalcemia in preterm infants. Postnatal calcium homeostasis should be closely monitored in these infants.
期刊介绍：
Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.
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