MAGNESIUM DEFICIENCY--NEONATAL HYPOCALCEMIA IN DIABETIC MOTHERS' INFANTS

这项建议建立在我们对钙和镁的长期研究基础上。 围产期和糖尿病妊娠的动态平衡。它是 旨在检测婴儿胰岛素中的钙镁代谢 依赖糖尿病的母亲。被研究的婴儿来自于核心 糖尿病妇女随机分为I组，严格对照的临床试验 第二组为习惯控制组；第三组为晚入组受试者。在……里面 目前的建议是，糖尿病母亲的婴儿进一步随机 在分娩时分成两组，一组肌肉注射镁 硫酸盐和一个未经处理。要研究的假设是镁 缺钙是糖尿病婴儿低钙血症的主要机制 母亲，因此预防性服用镁在临床上 试验将预防这类婴儿的新生儿高钙血症。我们假设 出生时随机服用硫酸镁的婴儿将有更高的 血清镁、钙、甲状旁腺激素及类似物 12、24和72小时龄时的1，25-二羟基维生素D浓度 与随机接受不接受硫酸镁治疗的婴儿相比。自.以来 新生儿期的低镁血症和低钙血症可能相关。 有脑电异常，手足抽搐，抽搐， 心脏障碍，以及自传统治疗以来的新生儿 低钙血症(即钙盐)是许多潜在的原因。 并发症，出生时服用镁可能被证明是安全的， 钙疗法的简单替代方案。本研究还将采取 考虑到新生儿窒息的主要混杂变量和 早产儿，并允许测定镁的贡献 新生儿缺钙致低钙血症。

The proposal builds upon our long-term studies of calcium and magnesium homeostasis in the perinatal period and the diabetic pregnancy. It is designed to examine calcium-magnesium metabolism in infants in insulin dependent diabetic mothers. Infants studied are derived from the Core Clinical Trial of diabetic women randomized into Group I, strict control versus Group II, customary control; and Group III, late entry subjects. In the present proposal, infants of diabetic mothers are further randomized at the time of delivery into-two groups, one given intramuscular magnesium sulfate and one untreated. The hypothesis to be studied is that magnesium deficiency is the major mechanism for hypocalcemia in infants of diabetic mothers, and therefore prophylactic magnesium administration in a clinical trial will prevent neonatal hypercalcemia in such infants. We hypothesize that infants randomized to magnesium sulfate at birth will have higher serum magnesium, calcium, parathyroid hormone, and similar 1,25-dihydroxyvitamin D concentrations at 12, 24 and 72 hours of age when compared with infants randomized to receive no magnesium sulfate. Since hypomagnesemia and hypocalcemia in the neonatal period may be associated with electroencephalographic abnormalities, tetany, convulsions, and cardiac disturbances, and since traditional treatment of neonatal hypocalcemia (i.e. calcium salts) is responsible for many potential complications, magnesium administration at birth could prove to be a safe, simple alternative to calcium therapy. The present study also will take into account major confounding variables of neonatal asphyxia and prematurity, and allow the determination of the contribution of magnesium deficiency to neonatal hypocalcemia.