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May 29, 20260 citationsOpen Access

Hypocalcemia and Hypomagnesemia in Neonates with Convulsions in A Tertiary Level NICU: A Prospective Cross Sectional Study

MMMahmoud MahmoudAHAmira Mohammed HamedKHKhaled Hassan

Key Points

  • Assess serum calcium and magnesium levels in neonates with convulsions compared to healthy controls.
  • Prospective cross-sectional study involving 100 neonates with convulsions and 100 healthy controls.
  • Measurement of serum calcium, magnesium, sodium, potassium, blood sugar, and complete blood count in all subjects.
  • Statistical analysis to compare biochemical levels between groups.
  • Convulsions group showed significantly lower total and ionized calcium (p<0.001) and magnesium levels (p=0.015) compared to controls.
  • Random blood sugar was significantly lower in the convulsions group (p<0.001).
  • Total calcium and ionized calcium had specific cutoffs for detecting seizures with high specificity and varied sensitivity rates (p<0.001).

Abstract

Background: Seizures are common in the neonatal period and may be the first sign of neonatal dysfunction. The incidence of neonatal seizures has been reported to be 1.5 to 3 in 1,000 full term live births.Aim of the Work: To assess the levels of serum calcium and magnesium in neonates with neonatal convulsion.Patients and Methods: The study includes 100 full term neonates with neonatal convulsions and 100 healthy full-term neonates as controls. Serum calcium, magnesium, sodium, potassium and random blood sugar and complete blood count were estimated in all neonates.Results: There was significant decrease in total and ionized calcium and magnesium in convulsions group compared to control group (p0.05). Total calcium can detect convulsion at a cutoff 7.3 mg/dl with sensitivity, specificity, PPV and NPV was 31%, 100%, 100% and 59% respectively (p< 0.001). Also, Ionized calcium can detect convulsion at cutoff 4.1 mg/dl with sensitivity, specificity, PPV and NPV was 53%, 97%, 94.6% and 67.4% respectively (p< 0.001). Magnesium can detect convulsion at cutoff 1.3 mg/dl with sensitivity, specificity, PPV and NPV was 20%, 100%, 100% and 55.56% respectively (p=0.015). Random blood sugar can detect convulsion at cutoff 40 mg/dl with sensitivity, specificity, PPV and NPV was 41%,95%,89% and 61.7% respectively (p<0.001).Conclusions: This study showed that hypoglycemia, hypocalcemia, and hypomagnesemia were significantly associated with neonatal seizures. A thorough biochemical work up is necessary in all cases of neonatal seizure for early detection and effective treatment of biochemical abnormalities in neonatal seizure.

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Cite This Study

Mahmoud et al. (2025) studied this question.

synapsesocial.com/papers/6a192d7efab5b468c4416695https://doi.org/10.21608/anj.2024.316607.1102
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