Severe pre-eclampsia is associated with abnormal trace elements concentrations in maternal and fetal blood

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of Negev, Beer-Sheva, Israel.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (Impact Factor: 1.37). 10/2011; 25(7):1127-30. DOI: 10.3109/14767058.2011.624221
Source: PubMed


The study was aimed to compare trace elements concentrations in women with and without severe pre-eclampsia (PE).
A prospective case-control study was conducted comparing 43 parturients with severe PE (who received magnesium sulfate [MgSO4]) and 80 healthy parturients and their newborns, matched for gestational age and mode of delivery. Inductively coupled plasma mass spectrometry (ICPMS) was used for the determination of zinc (Zn), copper (Cu), selenium (Se) and magnesium (Mg) levels in maternal as well as arterial and venous umbilical cord serum.
Zn levels (µg/L) were significantly higher in fetal arterial and venous blood of the PE group (947.3 ± 42.5 vs. 543.1 ± 226, 911.1 ± 220.2 vs. 422.4 ± 145, p < 0.001; respectively). Se levels (µg/L) were significantly lower in maternal and fetal arterial and venous cord blood of the PE group (98.6 ± 24.2, 110.7 ± 19.4, 82 ± 17.8 vs. 111.6 ± 17.6, 82.1 ± 17.4 vs. 107.1 ± 25.7, p < 0.001; respectively). Cu levels (µg/L) were significantly lower in fetal arterial and venous cord blood (581.6 ± 367.4 vs. 949 ± 788.8, p = 0.022, 608.3 ± 418.1 vs. 866.9 ± 812.6, p = 0.001 respectively) but higher in maternal blood (2264.6 ± 751.7 vs. 1048 ± 851.1, p < 0.001). These differences remained significant while controlling for the mode of delivery. Mg levels were significantly higher in the PE group as compared with the control group.
Severe PE is associated with abnormal concentrations of Zn, Cu and Se. Therefore, trace elements may have a crucial role in the pathogenesis of severe PE.

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    ABSTRACT: The association between serum zinc level and preeclampsia (PE) remains controversial. A systematic literature search was performed in PubMed, Web of Science and Embase for relevant available articles. The articles were limited to those in English from January 1990 to April 2015. Observational studies evaluating the association between serum zinc level and PE were included. The I² was used to assess heterogeneity and the random effect model (REM) was adopted as the pooling method. The pooled standard mean difference (SMD) with 95% confidence interval (CI) was used to estimate the association between serum zinc level and PE. Seventeen observational studies were included. Compared with healthy pregnancy controls, PE patients have lower serum zinc level in 14 studies about total PE (SMD (95% CI): -0.587 (-0.963, -0.212), Z = 3.06, p for Z = 0.002; I² = 88.4%, p for I² < 0.0001). In subgroup analysis, a lower serum zinc level in PE patients compared with healthy pregnancy controls was observed in studies conducted in Asia, studies with zinc level measured in serum, and studies involving fasting participants. The SMD did not differ significantly between studies with healthy pregnancy controls matched by individual age (yes or no), and by individual gestational age (yes or no), respectively. Results from this meta-analysis indicate that serum zinc level in PE patients is significantly lower than that in healthy pregnancy controls. A moderate amount of zinc supplementation during pregnancy is advocated to reduce the incidence of PE.
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