Poster Session 3
Daniel J. Martingano, DO, MBA, PhD
Clerkship Director, IRB Chair, Associate Program Director / Division Chair
St. John's Episcopal Hospital-South Shore and William Carey University College of Osteopathic Medicine
Far Rockaway, New York, United States
Amanda F. Francis Oladipo, MD, MSCR (she/her/hers)
Director of Research
Hackensack University Medical Center
Hackensack, New Jersey, United States
Marwah Al-Dulaimi, MD (she/her/hers)
OB/GYN Resident
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Sandra Kumwong, MS
Medical Student
Touro College of Osteopathic Medicine-Harlem Campus
New York, New York, United States
Andrea Ouyang, MSc
Medical Student
William Carey University
Hattiesburg, Mississippi, United States
Lauren Cue, MD, BA (she/her/hers)
OB/GYN Resident
Rutgers University and the Jersey City Medical Center
Jersey City, New Jersey, United States
Ashley Nguyen, MD
OB/GYN Resident
St. John's Episcopal Hospital-South Shore
Far Rockaway, New York, United States
Francis X. Martingano, MD
Assistant Professor, Senior Minimally Invasive Surgeon
NYU Grossman School of Medicine - NYU Brooklyn
New York, New York, United States
Shailini Singh, MD
Director of Metabolic Syndrome
AtlantiCare Regional Medical Center
Pamona, New Jersey, United States
Alexander Ulfers, DO
Medical Director, Maternal Infant Care Center; Maj, USAF, MC
Walter Reed National Military Medical Center
Bethesda, Maryland, United States
Mark Rebolos, MD
Director of Patient Safety, Labor & Delivery
St. John's Episcopal Hospital-South Shore
Far Rockaway, New York, United States
Kristin Cohen, CNM, DNP
Women's Health Care Practitioner
RWJBarnabas Health - Trinitas Regional Medical Center
Elizabeth, New Jersey, United States
Donald Morrish, MD
Chief Executive Officer
St. John's Episcopal Hospital-South Shore
Far Rockaway, New York, United States
Iffath A. Hoskins, MD
Former ACOG President, Director of Labor & Delivery, Chief Safety Officer
Albert Einstein College of Medicine - Montefiore Medical Center
New York, New York, United States
Intravenous magnesium sulfate remains an essential medication for seizure prophylaxis in the context of severe preeclampsia (SPEC), with oral formulations reserved for non-severe comorbid conditions with inconsistent results. This study sought to determine the effect of oral magnesium supplementation as adjunctive treatment in pregnancies complicated by chronic hypertension (CHTN).
Study Design:
We conducted a multi-center, prospective observational study from 7/2022 to 7/2024 and included all pregnant women diagnosed with chronic hypertension requiring antihypertensive medication with gestational ages ranging from 24 0/7 through 38 0/7 weeks-gestation. All patients were prescribed low-dose aspirin prophylaxis. Monotherapy magnesium oxide and magnesium citrate were included as covariates. The primary outcomes included diagnosis of superimposed SPEC, new-onset headache (NOH) not relieved by acetaminophen monotherapy, and worsening hypertension requiring additional or initiation of antihypertensive medications, as discrete events. Patients with preexisting neurological or cardiac disorders or allergies to any included medications were excluded. Medication choice was determined by physician clinical assessment.
Results:
The study included 693 patients diagnosed with CHTN. 351 patients were given magnesium oxide and 342 patients were given magnesium citrate. Baseline demographic factors were not significantly different. Patients who received magnesium oxide were less likely to develop SPEC (30.1% v. 69.9% p=0.001) or NOH (14.1% v. 73.1%, p< 0.001) with a 14% (RR=0.86, 95% CI 0.68-0.93, p=0.004) and 33% (RR=0.67, 95% CI 0.41-0.82, p=0.002) decreased risk in adjusted models, respectively. In stratified analysis, patients with BMI < 30 kg/m2 who received magnesium oxide were less likely to require addition or initiation of antihypertensive medications (54.8% v. 22.9%, p = < 0.001). None of the primary outcomes were significant for patients receiving magnesium citrate.
Conclusion:
Magnesium oxide supplementation may be beneficial for patients with pregnancies complicated by CHTN.
