Serum Magnesium and Nitric Oxide Levels in Early Detection of Pre-eclampsia and Gestational Hypertension

Background: Pre-eclampsia (PE) and gestational hypertension (GH) are commonly grouped under hypertensive disorders of pregnancy. An imbalance in angiogenic markers and increased oxidative stress are suggested as causative factors for the endothelial dysfunction seen in PE and GH. Magnesium is essential for endothelial cell proliferation, while nitric oxide (NO) is a well-established vasodilator. Placental hypoxia and reduced levels of NO contribute to oxidative stress. Measuring NO levels during the first and second trimesters of pregnancy may indicate hypertension-associated changes. Objectives: To identify serum levels of magnesium and NO during the first and second trimesters of pregnancy in order to analyze their differences in PE/GH and to predict the time of onset of PE/GH based on these biomarkers. Methods: Serum magnesium was measured using a colorimetric quantitative assay kit from Coral Clinical Systems, India. Serum NO was measured using the Griess method with a kit from AAT Bioquest, USA. Results: Serum magnesium levels were higher in the first trimester and lower in the second trimester among women who developed PE/GH. Serum NO levels were lower in both the first and second trimesters in the PE/GH group. The combined relative risk for predicting PE/GH with first-trimester magnesium ≥ 1.74 mEq/L and first-trimester NO ≤ 63.38 µmol/L was 4.4. For second-trimester magnesium ≤ 1.625 mEq/L and NO ≤ 50.49 µmol/L, the relative risk was 3. These findings were statistically significant. Conclusions: The study identified serum magnesium and NO as potential early predictors for the onset of PE/GH. However, further confirmation through larger studies is needed before these markers can be implemented in clinical practice.