Oral magnesium supplementation for leg cramps in pregnancy—An observational controlled trial

English version

Autoři: Carla Adriane Leal de Araújo ^aff001; Suélem Barros de Lorena ^aff002; Guilherme Camelo de Sousa Cavalcanti ^aff002; Gabriel Landim de Souza Leão ^aff002; Geraldo Padilha Tenório ^aff002; João Guilherme B. Alves ^aff001
Působiště autorů: Department of Pediatrics, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil ^aff001; Department of Pediatrics, Faculdade Pernambucana de Saúde (FPS), Recife, Pernambuco, Brazil ^aff002
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0227497

Souhrn

Background

Oral magnesium for leg cramps treatment in pregnancy is a controversial issue according to recent Cochrane systematic review. This study aims to evaluate the efficacy of Mg⁺⁺ supplementation in leg cramps treatment in pregnancy.

Methods

This observational clinical trial studied 132 pregnant women with leg cramps in the first trimester of pregnancy. At baseline, 74 (56.3%) had two leg cramps episodes per week, 28 (21.1%) three episodes, 13 (9.8%) four episodes and 9 (6.8%) five or more episodes. They were randomized 1:1 to 300 mg/day of oral Mg⁺⁺ citrate (n = 66) or placebo (n = 66). The primary outcome was the frequency of leg cramps episodes per week reported by pregnant women. Secondary outcomes were the ocurrence of leg cramps and oral magnesium side effects.

Results

130 pregnant women completed the study and the two groups were comparable according to some sociodemographic and clinical characteristics. After 4 weeks of intervention it was observed a 28.4% (39/132) (CI 95%: 20.9–37.0) reduction of leg cramps in all participants and no difference between the two groups was found; reduction of 27.2% (18/66) (CI 95%: 17.0–39.6) in Mg++ group and 32.8% (21/66) (CI 95%: 21.6–45.7) in the placebo group. The OR of leg cramps was 1.3 (CI 95%: 0.6–2.9), p = 0.527, taking the placebo group as reference. Among pregnant women who remained with leg cramps the mean of leg cramps episodes per week showed no significance difference between the Mg++ and placebo groups; t-student test: p = 0.408. Four pregnant women showed gastrointestinal side effects; 2 in each group had nauseas and diarrhoea.

Conclusion

Oral magnesium supplementation during pregnancy did not reduce the ocurrence and frequency of episodes of leg cramps.

Klíčová slova:

Pregnancy – Systematic reviews – Legs – Diarrhea – Randomized controlled trials – Gastrointestinal analysis – Magnesium – Nausea

Zdroje

1. Young G. Leg Cramps. BMJ Clin. Evid. 2015;.

2. Zhou K, West HM, Zhang J, Xu L, Li W. Interventions for leg cramps in pregnancy (Review). Cochrane Database Syst Rev 2015; 8:CD010655.

3. Ponnapula P, Boberg JS. Lower extremity changes experienced during pregnancy. The Journal of Foot & Ankle Surgery.2010; 49:452–8.

4. Hall H, Lauche R, Adams J, Steel A, Broom A, Sibbritt D. Healthcare utilisation of pregnant women who experience sciatica, leg cramps and/or varicose veins: A cross-sectional survey of 1835 pregnant women. Women and Birth 2016; 29:35–40. doi: 10.1016/j.wombi.2015.07.184 26314622

5. Shwalfenberg GK, Genuis SJ. The importance of magnesium in clinical healthcare. Hindawi 2017; Article ID 4179326:14.

6. Ahmed F, Mohammed A. Magnesium: The Forgotten Electrolyte-A Review on Hypomagnesemia. Med Sci (Basel). 2019 4;7(4). doi: 10.3390/medsci7040056 30987399

7. Dalton LM, Ní Fhloinn DM, Gaydadzhieva GT, Mazurkiewicz OM, Leeson H, Wright CP. Magnesium in pregnancy. Nutr Rev. 2016;74(9):549–57. doi: 10.1093/nutrit/nuw018 27445320

8. Plećas D, Plesinac S, Kontić Vucinić O. Nutrition in pregnancy: basic principles and recomendations. Srp Arh Celok Lek. 2014; 142(1–2):125–30. doi: 10.2298/sarh1402125p 24684045

9. Darnton-Hill I, Mkparu UC. Micronutrients in pregnancy in low- and middle-income countries. Nutrients. 2015;7(3):1744–68. doi: 10.3390/nu7031744 25763532

10. Makrides M, Crosby DD, Bain E, Crowther CA. Magnesium supplementation in pregnancy (Review). Cochrane Database Syst Rev 2014; 4:CD000937.

11. Sebo P, Cerutti B, Haller DM. Effect of magnesium therapy on nocturnal leg cramps: a systematic review of randomized controlled trials with meta-analysis using simulations. Fam Pract. 2014;31(1):7–19. doi: 10.1093/fampra/cmt065 24280947

12. Garrison SR, Allan GM, Sekhon RK, Musini VM, Khan KM. Magnesium for skeletal musclecramps (Review). Cochrane Database Syst Rev 2012; 9:CD009402.

13. Alves JG, de Araújo CA, Pontes IE, Guimarães AC, Ray JG. The BRAzil MAGnesium (BRAMAG) trial: a randomized clinical trial of oral magnesium supplementation in pregnancy for the prevention of preterm birth and perinatal and maternal morbidity. BMC Pregnancy Childbirth. 2014 8;14:222. doi: 10.1186/1471-2393-14-222 25005784

14. Nygaard IH, Valbo A, Pethick SV, Bohmer T. Does oral magnesium substitution relieve pregnancy-induced leg cramps?. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2008; 141(1):23–26. doi: 10.1016/j.ejogrb.2008.07.005 18768245

15. Dahle LO, Berg G, Hammar M, Hurtig M, Larsson L. The effect of oral magnesium substitution on pregnancy-induced leg cramps. American Journal of Obstetrics and Gynecology 1995; 173(1):175–80. doi: 10.1016/0002-9378(95)90186-8 7631676

16. Supakatisant C, Phupong V. Oral magnesium for relief in pregnancy-induced leg cramps: a randomised controlled trial. Maternal & Child Nutrition 2015; 11(2):139–45.

17. Zarean E, Tarjan A. Effect of Magnesium Supplement on Pregnancy Outcomes: A Randomized Control Trial. Adv Biomed Res. 2017;6:109. doi: 10.4103/2277-9175.213879 28904937