Association of Hypocalcemia and Hypomagnesemia with Maternal and Fetal Outcomes in Preeclamptic Pregnancies

Background: Preeclampsia remains a significant contributor to maternal and fetal morbidity and mortality worldwide. Recent evidence suggests that alterations in serum calcium and magnesium levels may be associated with its pathophysiology. This study aims to evaluate the association between hypocalcemia, hypomagnesemia, and maternal-fetal outcomes in preeclamptic pregnancies. Methods: A cross-sectional observational study was conducted on 100 third-trimester pregnant women attending a tertiary care hospital, comprising 50 preeclamptic (Group A) and 50 normotensive controls (Group B). Sociodemographic data, obstetric history, blood pressure, and biochemical parameters including serum calcium, magnesium, albumin, and their urinary excretion were recorded. Fetal outcomes were assessed by birth weight and Apgar score. Data were analyzed using SPSS with appropriate statistical tests; p < 0.05 was considered significant. Results: Preeclampsia was more prevalent in women aged 18–40 years and among those from rural, low-income backgrounds. A significantly higher proportion of preeclamptic women had a family history of hypertension (80%) and a history of preeclampsia (22%) (p < 0.05). Serum calcium (7.87 ± 0.45 mg/dL), magnesium (1.38 ± 0.20 mmol/L), and albumin (3.03 ± 0.30 g/dL) were significantly lower in preeclamptic women (p < 0.001). Urinary calcium was reduced, and urinary albumin was elevated, indicating renal involvement. Fetal outcomes were adversely affected, with lower birth weights (2.39 ± 0.30 kg) and Apgar scores (5.98 ± 0.84). Strong negative correlations were observed between systolic blood pressure and biochemical markers, while birth weight positively correlated with serum calcium and magnesium. Conclusion: Hypocalcemia, hypomagnesemia, and hypoalbuminemia are significantly associated with preeclampsia and correlate with poor fetal outcomes. Early screening of these markers in pregnancy may offer predictive value for identifying women at risk, enabling timely intervention to reduce maternal and neonatal complications.