Numerous clinical studies had clarified the alliance between preeclampsia and disturbances in maternal biochemical macronutrients, involving serum calcium (Ca+2) and magnesium (Mg+2). Up till now, there is an escalated concern in benefitting from nutritional approach in the preeclampsia management with respect to calcium and magnesium supplementation. Aim of the work: To assess serum levels of calcium and magnesium in pregnant females who suffered from pre-eclampsia in comparison with normal

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... gnant ladies. Patient and methods: This study was a case-control one that recruited 100 pregnant women (50 pregnant preeclampsia cases and 50 normal pregnant females) from obstetrics clinics of Kafr El-Sheikh General hospital and El-Sayed Galal Hospital of Al-Azhar University after the 20 th week of gestation during the period of research from February 2020 to December 2020 for estimation off serum calcium and magnesium. Results: The mean serum calcium level in the control group was 8.99 ± 0.52 mg/ dl and mean serum magnesium level was 2.21 ± 0.3 mg/ dl both were higher than those in the patients group as the mean serum Ca+2 was 8.05 ± 0.51 mg / dl and mean serum Mg+2 level was 1.86 ± 0.25 mg / dl (P<0.001). The present study showed that calcium had significantly higher diagnostic accuracy than magnesium to differentiate normotensive pregnant women from preeclamptic pregnant women. ROC curve showed that the optimum cut off for calcium was 8.55 (mg/dL) with sensitivity of 80 % and specificity of 84%, PPV of 83.3%, NPV of 80.8%. Calcium had largest area under the curve (AUC= were 0.898; CI :( 0.840-0.956) (P<0.001), indicating its importance for predicting preeclampsia. While the cut off value of magnesium was less than 2.15(mg/dL), the sensitivity was 88%, specificity was 60%; an area under the ROC curve (AUROC) 0.806(95% CI: 0.721-0.891). In addition, ROC curve showed the optimum cut off for serum calcium was 8.15 (mg /dL) for predicting adverse outcome of pregnancy with sensitivity 60.6% and specificity 86.6%; an area under the ROC curve (AUROC) 0.792(95% CI: 0.701-0.883). While the cut off value of serum magnesium was less than 1.945(mg/dL), the sensitivity was 69.7%, specificity was 67.2% %; an area under the ROC curve (AUROC) 0.726(95% CI: 0.618-0.834). Conclusion: Both serum calcium and serum magnesium in preeclamptic pregnant women were lesser in comparison to their healthy pregnant counterparts. These outcomes support the postulation that there is a cause-consequence liaison between hypocalcaemia and hypomagnesaemia as potential etiologic factors incriminated in of preeclampsia pathogenesis.