Serum copper and pregnancy

Micronutrients during pregnancy and child psychomotor development: Opposite effects of Zinc and Selenium

Studies on the impact of micronutrient levels during different pregnancy periods on child psychomotor functions are limited. The aim of this study was to evaluate the association between maternal plasma concentrations of selected micronutrients, such as: copper (Cu), zinc (Zn), selenium (Se), and child neuropsychological development. The study population consisted of 539 mother-child pairs from Polish Mother and Child Cohort (REPRO_PL). The micronutrient levels were measured in each trimester of pregnancy, at delivery and in the cord blood. Psychomotor development was assessed in children at the age of 1 and 2 years using the Bayley Scales of Infant and Toddler Development. The mean plasma Zn, Cu and Se concentrations in the 1st trimester of pregnancy were 0.91±0.27mg/l, 1.98±0.57mg/l and 48.35±10.54μg/l, respectively. There were no statistically significant associations between Cu levels and any of the analyzed domains of child development. A positive association was observed between Se level in the 1st trimester of pregnancy and child language and motor skills (β=0.18, p=0.03 and β=0.25, p=0.005, respectively) at one year of age. Motor score among one-year-old children decreased along with increasing Zn levels in the 1st trimester of pregnancy and in the cord blood (β=-12.07, p=0.003 and β=-6.51, p=0.03, respectively). A similar pattern was observed for the association between Zn level in the 1st trimester of pregnancy and language abilities at one year of age (β=-7.37, p=0.05). Prenatal Zn and Se status was associated with lower and higher child psychomotor abilities, respectively, within the first year of life. Further epidemiological and preclinical studies are necessary to confirm the associations between micronutrient levels and child development as well as to elucidate the underlying mechanisms of their effects.

Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana

Deficiencies of micronutrients (zinc, iron, folic acid and iodine) during pregnancy are known causes of Low Birth Weight (LBW). Studies have documented status of one or two micronutrients amongst pregnant women (PW). However, no attempt has been made to concurrently assess the prevalence of multiple micronutrient deficiencies and the factors associated with them amongst PW.

OBJECTIVE

The present study was undertaken to assess the prevalence of multiple micronutrient deficiencies amongst PW in a rural area.

METHODS

A community based cross sectional survey was conducted in six villages of a rural area of district Faridabad in Haryana state, India during November 2000 and October 2001. All PW aged 18 years or more, with pregnancy duration of more than 28 weeks were enrolled. Data were collected on socio-economic status and other demographic parameters. Serum zinc, copper and magnesium levels were estimated by utilizing the Atomic absorption spectrophotometry (AAS); serum ferritin and folate was estimated by Enzyme Linked Immuno Sorbent Assay (ELISA) method and the Radio-Immuno Assay (RIA) method, respectively and serum thyroid stimulating hormone (TSH) level was estimated by the Abbot AxSYM System. Serum zinc, copper, magnesium, ferritin, and folate levels less than 70.0 microg/dl, 80.0 microg/dl, 1.80 mg/dl, 15 ng/ml, and 3 ng/ml, respectively were considered as indicative of deficiency for respective micronutrients. The TSH levels of 4.670 and more indicated iodine deficiency status. Dietary intake of micronutrients was assessed utilizing 1-day 24-hour dietary recall methodology. Food consumption pattern was assessed utilizing the food frequency questionnaire methodology.

RESULTS

Nearly 73.5, 2.7, 43.6, 73.4, 26.3, and 6.4 percent PW were deficient in zinc, copper, magnesium, iron, folic acid and iodine, respectively. The highest concurrent prevalence of two, three, four and five micronutrient deficiency was of zinc and iron (54.9%); zinc, magnesium and iron (25.6%); zinc, magnesium, iron and folic acid (9.3%) and zinc, magnesium, iron, folic acid and iodine (0.8%), respectively. No pregnant woman was found to have concomitant deficiencies of all the six micronutrients. Dietary intake data revealed an inadequate nutrient intake. Over 19% PW were consuming less than 50% of the recommended calories. Similarly, 99, 86.2, 75.4, 23.6, 3.9 percent of the PW were consuming less than 50% of the recommended folic acid, zinc, iron, copper, and magnesium. The consumption of food groups rich in micronutrients (pulses, vegetables, fruits, nuts and oil seeds, animal foods) was infrequent. Univariate and Multivariate logistic regression analysis revealed that low dietary intake of nutrients, low frequency of consumption of food groups rich in micronutrients and increased reproductive cycles with short interpregnancy intervals were important factors leading to micronutrient deficiencies.

CONCLUSION

There was a high prevalence of micronutrient deficiencies amongst the PW of the area, possibly due to the poor dietary intake of food and low frequency of consumption of food groups rich in micronutrients. The concurrent prevalence of two, three, four and five micronutrient deficiencies were common.

Copper and zinc levels in maternal and fetal cord blood

Serum copper and zinc were estimated in 44 mothers and their cord blood at term. The results were compared with 40 age-matched non-pregnant females and 67 males. The mean serum copper in the nonpregnant female group and in males was 114.6 (SD 30.43) and 111.3 (SD 30.79) micrograms/dl, whereas in mothers immediately after delivery it was 135.3 (+/- 26.26) micrograms/dl, which was significantly higher than the female control group (P less than 0.01). In fetal cord blood, it was 35% as compared to maternal blood. Serum zinc in control females and males was 112.8 (+/- 11.94) and 109.9 (+/- 15.69) micrograms/dl, respectively. In mothers it was 102.9 (+/- 17.04) micrograms/dl which was significantly lower than the female controls. In fetal cord blood, it was 98.6 (+/- 12.10) micrograms/dl. No significant difference could be obtained between maternal serum zinc and cord blood levels.

Study of serum copper and zinc in cases of hyperemesis gravidarum

The dehydration, electrolyte and metabolic changes which occur in hyperemesis gravidarum are well recognized. The aim of this paper was to study the changes in serum copper and zinc and their correlation with the changes in serum electrolytes that occur in patients with hyperemesis gravidarum. Serum copper, zinc, sodium and potassium and urinary chloride were measured in 30 patients suffering from hyperemesis gravidarum and compared to the levels in 10 normal pregnant women in their first trimester. There was no significant change in serum copper or zinc in patients with hyperemesis compared to normal pregnant women. Also, there was no significant correlation between the changes in the level of these trace elements and the decrease which occurred in serum sodium and potassium and urinary chloride.

Determination of trace and bulk elements in plasma and erythrocytes of healthy pregnant women by PIXE method

Particle Induced X-ray Emission (PIXE) analysis of blood samples from healthy pregnant women was carried out. Elements S, Ca, P, K, Cl, Fe, Zn, Cu, Rb and Br were detected, in red blood cells while S, Ca, P. K, Cl, Fe, Zn, Cu, Ni, Br in the plasma. The concentrations of Ca, K and Br were found to be stable throughout pregnancy, others exhibited significant alterations. The importance of macro- and microelement metabolisms during pregnancy and their role in the intrauterine development is summarized.

Distribution of serum selenium, copper, and zinc in normal human pregnancy

The distribution of the serum levels of selenium, zinc, and copper in human pregnancy at various gestational ages were determined from two ethnically and geographically different populations (Rosebud Indian Reservation and southeastern South Dakota) of 410 normal subjects. As gestation age increased, there was a significant increase and a slight decrease in the mean levels of copper and zinc, respectively. No change in the levels of selenium was observed. Significantly higher levels of both pregnancy and non-pregnancy serum copper were observed in the Rosebud population compared to that in southeastern South Dakota, possibly due to the significantly higher level of copper in the Rosebud water. No differences were observed in the zinc or selenium levels between the two populations. Serial measurements of these trace metals during the third trimester of pregnancy were performed on 18 subjects, and supported the trends described for copper and selenium. No decrease in zinc was observed in the individual subjects.

Hypercalcemia in the etiology of puerperal psychosis

The serum calcium of 53 recently delivered mothers hospitalized for severe puerperal psychiatric illness, which represented the whole intake from a defined catchment area, was compared with that of 35 female psychiatric patients and that of 49 normal postnatal women. The mean corrected and ionized serum calcium values of the puerperal psychiatric patients with no personal or family history of psychiatric disorder were markedly above the normal range. They were also significantly higher than those of the puerperal psychiatric patients with a personal or family history of psychiatric illness and those of the two control groups. There was a modest positive correlation between the degree of hypercalcemia and the severity of the psychiatric illness. The follow-up of 16 puerperal psychiatric patients indicated that the fall in ionized serum calcium levels correlated positively and significantly with the improvement in rated symptomatology. Patients with severe puerperal psychiatric disorder can be divided etiologically into two groups. The larger proportion is psychiatrically vulnerable, but in the remainder (about a third of the total number), the psychiatric illness appears to be related to a disorder of calcium homeostasis in the puerperium.

Correlation of erythrocyte and plasma levels of zinc, copper, and iron with evidence of metastatic spread in cancer patients

The level of plasma copper (Cu-Pl) and zinc (Zn-Pl) and the level of erythrocyte iron (Fe-RBC), copper (Cu-RBC), and zinc (Zn-RBC) were determined in the blood of 70 normal donors and 138 patients with various solid tumors by diagnostic x-ray spectrometry (DXS), a technique based on x-ray fluorescence spectrometry analysis. There were no significant changes in the mean values of Zn-Pl, Fe-RBC, and Cu-RBC in the patients when compared with those of normal donors. The mean level of Cu-Pl in the normal donors was 1.34 +/- 0.37 micrograms/ml; it was significantly increased in the patients, ranging between 1.47 +/- 0.34 micrograms/ml for patients without evidence of active cancer (NED) and 1.91 +/- 0.76 micrograms/ml for patients with hepatic metastases. The most significant change observed was an increase in the Zn-RBC found in the patients with clinical evidence of metastatic spread. Whereas the Zn-RBC level in the normal donors was 9.85 +/- 1.47 micrograms/g wet weight, and not significantly elevated in the NED patients, it was elevated to values of 11.37 +/- 1.55 micrograms/g (P less than 0.004) for patients with soft tissue and hepatic metastases and was 12.34 +/- 1.65 micrograms/g (P less than 0.001) for patients with bone metastases. The data suggest a clear correlation between Zn-RBC and metastatic spread in nonlymphomatous human cancer.

5-Hydroxytryptamine (serotonin), copper and ceruloplasmin plasma concentrations in spontaneous abortion

Ceruloplasmin, the blue copper-protein of the blood plasma, is believed by some workers to be involved in the metabolic management of 5-hydroxytryptamine (serotonin) during pregnancy. 5-Hydroxytryptamine is abortifacient in experimental animals. By some authors, a role has been suggested for it in human abortion. The plasma concentrations of 5-hydroxytryptamine, copper and ceruloplasmin were measured in non-pregnant women, in normal early pregnancy and in cases of spontaneous abortion. Compared with normal early pregnancy, cases of inevitable abortion show lower values for both plasma copper and ceruloplasmin and higher values for plasma 5-hydroxytryptamine. The possible implications of these findings are discussed in view of the alterations in ceruloplasmin values in pregnancy and in the light of what is known of the pharmacology and metabolism of 5-hydroxytryptamine. It it believed that these alterations in plasma copper, ceruloplasmin and 5-hydroxytryptamine in cases of inevitable abortion are the effect, rather than the cause, of abortion.

Lipofuscin (aging) pigment granules of the newborn human liver

We have observed pigmented cytoplasmic granules, with the characteristic staining properties of lipofuscin (ceroid, "wear-and-tear") pigment, in newborn human liver. The pigment is found at the periphery of the lobule in hepatocytes and some bile ductular cells. It is acid-fast, PAS-positive after diastase digestion, slightly argyophilic and sudanophilic, and markedly Schmorl's- and peroxidase positive in paraffin sections. Difficult to see in sections stained with hematoxylin and eosin, the pigment can be detected in unstained sections. The granules also resemble lipofuscin found in adult tissues, in their ultra-structural and enzymatic properties. They are polymorphic, contain granular material of moderate and high electron opacity, and are delimited by a single membrane. Acid phosphatase and beta-glucuronidase activities are visualized in the newborn granules, identifying them as lysosomes. The granules also contain copper and, to a much lesser extent, iron. The accumulation of lipofuscin pigment in lysosomes in many tissues correlates well with aging, and this process has been interpreted as a reflection of cellular degeneration or wear-and-tear. However, the presence of lipofuscin granules as a constant component of neonatal liver suggests that they are not a measure of cellular senescence.