Comparative study of copper, zinc, iron, ferritin, calcium and magnesium levels in pregnancy induced hypertension and normotensive primigravida mothers

Soumi Biswas, Abhishek Roy, Srabani Biswas


Background: Exact pathophysiology of pregnancy induced hypertension (PIH) is still unknown but there is a definite relationship between trace elements and preeclampsia. Several studies in this context have conflicting reports. So, a comparative study of serum levels of copper (Cu), zinc (Zn), iron (Fe), ferritin, calcium (Ca) and magnesium (Mg), in PIH and normotensive primipara mothers was conducted.

Methods: Study was conducted in Department of Biochemistry & Department of Gynaecology and Obstetrics, R. G. Kar Medical College & Hospital, Kolkata over 1 year from September 2013 to August 2014 on fifty PIH patients as cases and fifty normotensive primipara mother without proteinuria as controls, both having ages ranging between 15-35 years in 2nd and 3rd trimesters.

Results: Serum Ca, Mg, Cu and Zn levels were found to be significantly reduced (<0.05) in the PIH group compared to the normal pregnant group. Serum ferritin was markedly increased in the cases (mean 90.41±47.39, p<0.00001). No significant correlation was found in serum Fe levels.

Conclusions: Alteration of serum Cu, Zn, Ca, Mg and ferritin levels can be considered to have a role in the etiopathogenesis and severity of PIH.



Copper, Zinc, Iron, Ferritin, Calcium, Magnesium, Pregnancy induced hypertension

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Janga D. Pregnancy induced hypertension:a complication of pregnancy. Obs Gyne today. 2005;X(7):395-8.

Indumati K, Kodliwadmath MV, Sheela MK. The role of serum electrolytes in pregnancy induced hypertension. J Clin Diagnos Res. 2011;5(1):66-9.

Walker JJ. Pre-eclampsia. Lancet. 2000;356:1260-5.

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785-99.

James DK, Seely PJ, Weiner CP, Gonlk B. High risk pregnancy: management options. 3rd ed. Philadelphia: Sauders; 2006:920-5.

Pallavi PC, Pranay AJ, Jasmin HJ. Changes in serum calcium and Magnesium level in preeclampsia vs normal pregnancy. Intern J Biomed Adv Res. 2012;3(6):511-3.

Rayman MP, Bode P, Redman CW. Low selenium status is associated with the occurrence of the pregnancy disease preeclampsia in women from the United Kingdom. Am J Obstet Gynaecol. 2003;189:134-9.

Liu J, Yang H, Shi H, Shen C, Zhou W, Dai Q, et al. Blood copper, zinc, calcium, and magnesium levels during different duration of pregnancy in Chinese. Biol Trace Element Res. 2010;135(1-3):31-7.

Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington DC, USA: National Academy Press; 2001: 299.

McArdle HJ, Andersen HS, Jones H, Gambling L. Copper and iron transport across the placenta: regulation and interactions. J Neuroendocrinol. 2008;20(4):427-31.

Department of Health, Dietary reference values for food energy and nutrients for the United Kingdom, Report on Social Subjects no. 41, HMSO, London, UK; 1991.

Kolusari A, Kurdoglu M, Yildizhan R, Adali E, Edirne T, Cebi A, et al. Catalase activity, serum trace element and heavy metal concentrations, and vitamin A, D and E levels in pre-eclampsia. J Intern Med Res. 2008;36(6):1335-41.

de Moraes ML, de Faria Barbosa R, Santo RE, da Silva Santos F, de Jesus EF, Sardinha FL et al. Maternal-fetal distribution of calcium, iron, copper, and zinc in pregnant teenagers and adults. Biol Trace Element Res. 2011;139(2):126-36.

Izquierdo Álvarez S, Castañón SG, Ruata ML, Aragüés EF, Terraz PB, Irazabal YG et al. Updating of normal levels of copper, zinc and selenium in serum of pregnant women. J Trace Elements Med Biol. 2007;21(Supplement 1):49-52.

Kiilholma P, Paul R, Pakarinen P, Gronroos M. Copper and zinc in pre-eclampsia. Acta Obstetricia et Gynecologica Scandinavica. 1984;63(7):629-31.

Cherry FF, Bennett EA, Bazzano GS. Plasma zinc in hypertension/toxemia and other reproductive variables in adolescent pregnancy. American J Clin Nutr. 1981;34(11):2364-75.

Bassiouni BA, Foda AI, Rafei AA. Maternal and fetal plasma zinc in pre-eclampsia. European J Obstetr Gynecol Reprod Biol. 1979;9(2)75-80.

Díaz E, Halhali A, Luna C, Díaz L, Avila E, Larrea F. New born birth weight correlates with placental zinc, umbilical insulin-like growth factor I, and leptin levels in preeclampsia. Arch Med Res. 2002;33(1)40-7.

Açikgoz S, Harma M, Harma M, Mungan G, Can M, Demirtas S. Comparison of angiotensin-converting enzyme, malonaldehyde, zinc, and copper levels in preeclampsia. Biol Trace Element Res. 2006;113(1):1-8.

Kumru S, Aydin S, Simsek M, Sahin K, Yaman M, Ay G. Comparison of serum copper, zinc, calcium, and magnesium levels in pre-eclamptic and healthy pregnant women. Biol Trace Element Res. 2003;94(2):105-12.

Jain S, Sharma P, Kulshreshtha S, Mohan G, Singh S. The role of calcium, magnesium, and zinc in pre-eclampsia. Biol Trace Element Res. 2010;133(2):162-70.

Dawson EB, Evans DR, Nosovitch J. Third-trimester amniotic fluid metal levels associated with preeclampsia. Arch Environment Health. 1999;54(6):412-5.

Roggensack AM, Zhang Y, Davidge ST. Evidence for per oxynitrite formation in the vasculature of women with pre eclampsia. Hypertension. 1999;33:83-9.

Hubel CA, Kozov AV, Kagan EV, Evans RW, Davidge ST, McLaughin MK et al. Decreased transferrin and increased transferrin saturation in sera of women with pre eclampsia. Implications for oxidative stress. Am J Obstet Gynecol. 1996;175:692-700.

Theresa OS. High third trimester ferritin concentration. Association with very preterm delivery, infection and maternal nutritional status. Obstet, Gynaecol. 1998;92:161-6.

Basher K, Deb K. Alteration in iron status in pre eclampsia. Mymensingh Med J. 2006;15(1):22-4.

Migneco A, Ojetti V, De Lorenzo A, Silveri NG, Savi L. Hypertensive crises: diagnosis and management in the emergency room. Eur Rev Med Pharmacol Sci. 2004;8:143-52.

Chun MJ, Korbet SM, Schwartz MM, Lewis EJ. Focal segment glomerulo sclerosis in nephrotic adults, presentation, prognosis and response to therapy of the histologic variants. J Am Soc Nephrol. 2004;15:2169-77.

Theresa OS. Iron status during pregnancy, setting the stage for mother and infant. American Journal of Clinical Nutritin. 2005;81(5):1218S-22S.

Sibai BM. Diagnosis, prevention and management of eclampsia. Obstect Gynecol. 2005;105:402.

Warnock DG. Towards a definition and classification of acute kidney injury. J Am Soc Nephrol. 2005;16:3149-50.

Chanvitya P, Boonsri K. Serum calcium, magnesium & uric acid in preeclampsia & normal pregnancy. J Med Assoc Thailand. 2008;91(7):968-73.

Selina A, Shelina B, Sultana F. Calcium and Zinc deficiency in preeclamptic women. Journal of Bangladesh Soc Physiol. 2011;6(2):94-9.

Abdelmarouf HM, Asma AD, Yousif HM, Hamza MA. Serum calcium levels as a marker of pregnancy induced hypertension. Sudan J Med Sci. 2007;2(4):245-8.