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Comparison of Maternal Serum Zn, Cu, Mg and Fe with Dual Test Scores in Pregnant Women with Adverse Pregnancy Outcomes
Authors: sairoz sairoz, Montey Naruka, rupesh kumar, Vidyashree G Poojari, Krishnananda prabhu RV.
DOI: 10.18231/j.ijogr.11506.1758783678
Keywords: Pregnancy, Adverse pregnancy outcomes, first trimester, zinc, copper, magnesium, iron
Abstract: The dual test is the most used aneuploidy screening method in first-trimester pregnancy. Abnormally high or low values of PAPP-A and β hCG are associated with adverse pregnancy outcomes. Increased free β -hCG were associated with pregnancy complications including late foetal loss, gestational hypertension, pre-eclampsia, FGR(Foetal growth restriction), preterm delivery and dead fetus in utero. Score developed in dual test does not consider maternal trace elements in the prediction of APO. There have been no studies correlating serum trace elements with PAPP-A, beta HCG CRL, NT and aneuploidy risk among pregnancies that had APO. So, this study attempted to associate serum micronutrients, PAPP-A and aneuploidy risk score generated by dual test in pregnant women aged 20-40 years in first trimester of pregnancy with different APO. This cohort study was carried out in Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka,India, from March2019 to March2022, after obtaining approval from the Institutional Ethical Committee (IEC No 182/2019). The study has been registered under “The ClinicalTrialsRegistryIndia,” -REF/2020/01/030393. The pregnancy was followed up and we found n=102 mothers had normal delivery, n=46 had FGR, n=57 had gestational diabetes mellitus and n=68 had preterm delivery. In FGR group, serum zinc showed positive relation with PAPPA (r=0.7, p<0.001) and Multiple of Median (MoM) of PAPPA (r=0.77, p<0.001). Maternal serum zinc showed a significant positive correlation with PAPP-A in FGR group supporting the association between these two parameters. The possible role of serum micronutrient and zinc deficiency in relation to Down syndrome needs to be further explored.