Prabhu Krishnananda, Poojari Vidyashree G, Shetty Sahana, Rao Mahadeva, Kamath Asha
Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka India.
Obstetrics and Gynecology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
Indian J Clin Biochem. 2023 Jan;38(1):128-131. doi: 10.1007/s12291-022-01043-x. Epub 2022 May 3.
Twenty five percent of pregnant women have some degree of vaginal bleeding during the first trimester, and about 50% of those pregnancies end in spontaneous abortion (SA) because the fetus is not developing typically. As studies have reported that inadequacies of trace metals such as Copper (Cu), Zinc (Zn), Magnesium (Mg) can predispose to various adverse pregnancy outcomes (PO); multiple micronutrient (MMN) supplementations are given without justifying their deficiency and toxicities on the fetus. Earlier studies on effects of MMN supplementations during pregnancy have not considered the need, duration, dose, and time of initiation of supplementations leading to inconclusive results. So, there is a need to optimize this to prevent their abuse and side effects. This study can help in establishing critical cut-offs of these minerals in maternal serum that can forecast future pregnancy outcomes. Study measured the serum Zn, Cu, Mg, and Fe in pregnant women who presented with ( = 80) and without ( = 100) SA at 5-2 weeks of pregnancy using iron -ferrozine method, magnesium-calmagite method, zinc reaction with nitro-PAPS, copper reaction with Di-Br- PAESA methods, respectively. Data analyzed using the student t test and cutoff value was established using Receiver Operating Characteristic (ROC) by SPSS software. Maternal serum Cu, Mg, Fe, and Zn levels measured were significantly lower in SA as compared to that of controls ( < 0.005) (Fig. 1) and maternal age and Body mass index were not statistically significant different among study group. Maternal serum Cu, Mg, Zn and Iron (Fe) measured in 5-12 weeks of pregnancy has the potential to forecast future occurrence of SA. The study has been registered under "The Clinical Trials Registry- India (CTRI)," -REF/2020/01/030393.
25%的孕妇在孕早期会出现一定程度的阴道出血，其中约50%的妊娠会以自然流产告终，因为胎儿发育不正常。正如研究报告所述，铜（Cu）、锌（Zn）、镁（Mg）等微量元素的不足可能导致各种不良妊娠结局；在未明确胎儿缺乏及毒性的情况下就给予多种微量营养素（MMN）补充剂。早期关于孕期补充MMN效果的研究没有考虑补充的必要性、持续时间、剂量和起始时间，导致结果不明确。因此，有必要对此进行优化，以防止滥用和产生副作用。本研究有助于确定孕妇血清中这些矿物质的临界值，从而预测未来的妊娠结局。该研究分别采用铁-菲罗嗪法、镁-钙镁试剂法、锌与硝基-PAPS反应法、铜与二溴-PAESA反应法，测定了妊娠5-12周时出现（n = 80）和未出现（n = 100）自然流产的孕妇血清中的锌、铜、镁和铁。使用学生t检验进行数据分析，并通过SPSS软件利用受试者工作特征（ROC）确定临界值。与对照组相比，自然流产组孕妇血清铜、镁、铁和锌水平显著降低（P < 0.005）（图1）研究组间孕妇年龄和体重指数无统计学差异。在妊娠5-12周时测定的孕妇血清铜、镁、锌和铁有预测未来自然流产发生的潜力。该研究已在“印度临床试验注册中心（CTRI）”注册，注册号为-REF/2020/01/030393。
