First Trimester Microelements and Their Relationships with Pregnancy Outcomes and Complications

Abstract

Microelements involved in the oxidative balance have a significant impact on human health, but their role in pregnancy are poorly studied. We examined the relationships between first trimester levels of selenium (Se), iron (Fe), zinc (Zn), and copper (Cu), as well as maternal characteristics and pregnancy results. The data came from a Polish prospective cohort of women in a single pregnancy without chronic diseases. A group of 563 women who had a complete set of data, including serum microelements in the 10–14th week was examined, and the following were found: 47 deliveries <37th week; 48 cases of birth weight <10th and 64 newborns >90th percentile; 13 intrauterine growth restriction (IUGR) cases; 105 gestational hypertension (GH) and 15 preeclampsia (PE) cases; and 110 gestational diabetes mellitus (GDM) cases. The microelements were quantified using mass spectrometry. The average concentrations (and ranges) of the elements were as follows: Se: 60.75 µg/L (40.91–125.54); Zn: 618.50 µg/L (394.04–3238.90); Cu: 1735.91 µg/L (883.61–3956.76); and Fe: 1018.33 µg/L (217.55–2806.24). In the multivariate logistic regression, we found that an increase in Se of 1 µg/L reduces the risk of GH by 6% (AOR = 0.94; p = 0.004), the risk of IUGR by 11% (AOR = 0.89; p = 0.013), and the risk of birth <34th week by 7% (but close to the significance) (AOR = 0.93; p = 0.061). An increase in Fe of 100 µg/L reduces the risk of PE by 27% (AOR = 0.73; p = 0.009). In the multivariable linear regression, we found negative strong associations between prepregnancy BMI, Se (β = −0.130; p = 0.002), and Fe (β = −0.164; p < 0.0001), but positive associations with Cu (β = 0.320; p < 0.000001). The relationships between Se and maternal age (β = 0.167; p < 0.0001), Se and smoking (β = −0.106; p = 0.011) and Cu, and gestational age from the 10–14th week (β = 0.142; p < 0.001) were also found. Secondary education was associated with Zn (β = 0.132; p = 0.004) and higher education was associated with Cu (β = −0.102; p = 0.023). A higher financial status was associated with Fe (β = 0.195; p = 0.005). Other relationships were statistically insignificant. Further research is needed to clarify relationships between first trimester microelements and pregnancy complications. In addition, attention should be paid to lifestyle-related and socioeconomic factors that affect microelement levels.

The Influence of Maternal BMI on Adverse Pregnancy Outcomes in Older Women

“…Obesity (which in our study exacerbated the effects of age) has been associated with increased oxidative stress and inflammation, as well as with significant changes in the level of chemical compounds with antioxidant properties [11,27]. Relations between obesity and higher risk of preeclampsia, fetal growth restriction, or preterm birth can suggest that obesity is the cause of placental dysfunction [24].…”

“…At the same time, associations between obesity and placental dysfunction were found [24]. Obesity is associated with insulin resistance, increased oxidative stress, and inflammation [11,24,27]. The risk of obesity increases along with the age [20].…”

“…One of the key elements in the pathogenesis of adverse pregnancy outcomes (such as hypertension, diabetes, premature birth, or fetal growth restriction) is increased oxidative stress. A higher risk of these pregnancy complications has been associated with lower levels of antioxidants [10][11][12][13][14][15][16]. This suggests that the oxidative stress associated with aging may increase the risk of pregnancy complications.…”

Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity

“…Mechanisms of the relations between smoking during pregnancy and inappropriate weight at birth have not been explained yet. The effect of multi-direction impacts of different components of cigarette smoke on complex multi-factor processes associated with the fetal growth are difficult to assess [12,13]. In addition to genetic factors, the main factors affecting fetal growth include the placenta, which guarantees the flow of nutrients to the fetus [14][15][16], as well as the mother's nutritional status [13] and environmental factors [14].…”

“…Blood flow reductions in placenta, placental ischemia, hypoxia, and intensified oxidative stress and inflammation have been identified as key elements of pathogenesis of adverse fetal outcomes. Lower levels of antioxidants in maternal serum have been associated with a higher risk of FGR [12] and birth weight <10th percentile [13].…”