ArticlePediatric research2026
Neonatal hypocalcemia caused by maternal hypercalcemia: clinical characteristics, etiology, treatment, and outcome.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMaternal hypercalcemia is a rare but potentially serious cause of late-onset neonatal hypocalcemia. Data on the clinical characteristics and outcomes of mother-baby couplets with maternal hypercalcemia and subsequent neonatal hypocalcemia remains scarce.
methodsThis retrospective study reviewed medical records of neonates with late-onset hypocalcemia (≥3 days after birth) caused by maternal hypercalcemia at a tertiary medical center in Taiwan from 2014 to 2021. A stepwise diagnostic approach was applied to exclude other secondary causes. The etiologies of maternal hypercalcemia were assessed. Clinical outcomes and treatment responses of the mother-infant dyads were extracted from follow-up records documented during routine clinical care.
resultsA total of seven neonates (6 males, 1 female) were documented. All affected neonates presented with seizure between 5 and 12 days of age. Laboratory findings revealed hypocalcemia (median: 5.3 mg/dL), hyperphosphatemia (median: 10.2 mg/dL), inappropriately intact parathyroid hormone (median: 18.4 pg/mL), and low 25-hydroxyvitamin D
conclusionsLate-onset neonatal hypocalcemia should prompt maternal calcium evaluation even in asymptomatic mothers. Maternal total serum calcium levels ≥11 mg/dL may require more intensive neonatal monitoring and prolonged treatment. Genetic testing should be considered in mother with negative result of parathyroid scan. IMPACT: This study provides the first comprehensive analysis of maternal hypercalcemia-induced neonatal hypocalcemia, identifying functional parathyroid adenomas as the predominant cause (86%). Maternal calcium levels ≥11 mg/dL correlate with more severe neonatal hypocalcemia, establishing evidence-based risk stratification for clinical management. Emphasizes routine maternal calcium screening in late-onset neonatal hypocalcemia and genetic testing when parathyroid imaging is negative. Demonstrates excellent prognosis with complete biochemical normalization in all neonates within three months and minimal long-term neurodevelopmental sequelae.
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