Impact of magnesium levels in pregnancy on adverse birth outcomes: a protocol for a systematic review and meta-analysis

Background: Magnesium, an often-overlooked trace element, may play a pivotal role in maternal and fetal health outcomes during pregnancy. Magnesium deficiency has been observed to contribute to several maternal complications, such as intrauterine growth restriction, pregnancy-induced hypertension and pre-eclampsia. Pre-eclampsia, a hypertensive disorder of pregnancy, presents substantial risks to both maternal and fetal health. Magnesium sulphate is a cornerstone in the management of pre-eclampsia, underscoring the importance of magnesium in pregnancy. Notably, pre-eclampsia is more prevalent in low-to-middle-income countries, where other co-morbidities such as HIV, anaemia and obesity are also common. Understanding the dynamics of magnesium levels in pregnancy and their interactions with co-morbidities could be critical for improving maternal and fetal health outcomes worldwide. Method: This protocol is for a systematic review and meta-analysis that aims to comprehensively map the literature on magnesium levels in pregnancy. Following the Preferred Reporting Items for Systematic Review and Meta-analysis for Protocols guidelines, our study will provide a rigorous synthesis of available evidence. By conducting a thorough search across multiple databases, including PubMed, Scopus, Directory of Open Access Journals, and Google Scholar, we aim to identify studies reporting on magnesium levels during pregnancy. Through screening and data extraction, we will analyze the association between magnesium levels and pregnancy complications, with further exploration of the impact of co-morbidities on magnesium status in pregnancy. Discussion: The findings of this study may have the potential to affect maternal and fetal health outcomes globally. Improved understanding of magnesium's role in pregnancy physiology can guide targeted interventions aimed at reducing the burden of pre-eclampsia and its associated complications, particularly in low-to-middle-income countries where maternal and infant mortality rates remain unacceptably high. Prospero Registration: CRD42024518427