Elementary metabolomics and affordable tools for screening, diagnosis and treating hypomagnesemia in pregnancy
The article addresses matters related to the replenishment of the magnesium deficiency in pregnant women. Two multicenter studies conducted in Russia in 2012 and 2013 showed that magnesium deficiency was diagnosed in 81% of pregnant women. The presented article states that the magnesium status study has some limitations and should be comprehensive, including the symptom assessment using MDQ questionnaires and the measurement of the level of magnesium in the blood by laboratory tests. This work assessed the effects of magnesium deficiency on pregnancy outcomes. The systematic reviews of randomized clinical studies in pregnant women without magnesium deficiency did not detect the positive effect of magnesium supplements on reduction of the incidence of complications, and, on the contrary, if the magnesium deficiency is diagnosed, the frequency of complications, including gestational hypertension, preeclampsia, premature birth, low birth weight has been significantly reduced. The article discusses the issues of hypomagnesemia diagnosis and rational therapy with magnesium supplements and provides the analysis of the data on bioavailability, accumulation rate, dose determination, possibilities and feasibility of administration combined with other micronutrients. If the magnesium deficiency is diagnosed, it is necessary to replenish it with a combination of organic Mg-containing agents and pyridoxine at adjusted dosages. The advantages of oral magnesium citrate compared with other salts are due to its high bioavailability, delivery of magnesium to the cells, and complete utilization in the Krebs cycle. The intake of vitamin-mineral complexes for pregnant women is not a limitation for taking additional magnesium-containing supplements in women with Mg deficiency.