The Importance Of Measuring Serum Zinc Levels During Pregnancy

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1 The Importance Of Measuring Serum Zinc Levels During Pregnancy Entela Treska, Shpresa Thomaj, University Obs-Gyn Hospital Queen Geraldine, Tirana, Albania & Kozeta Vaso, Faculty of Natural Sciences, Chemistry Department, Tirana, Albania ABSTRACT Zinc is one of the microelements with an essential role in biochemical body-function regulating. Deficiency of micronutrients during pregnancy may give rise to complications such as anemia and hypertension. We analyzed 50 cases of pregnant women, including anemic and normal pregnancies, (control group). Serum zinc level was measured directly using by Atomic Absorption Spectrometry (VARIAN AAS-220), these were measured at the same time using Colorimetry, in a way that we could compare the results. According to a statistical data processing, there was no significant difference between two methods of zinc levels determination. The prevalence of zinc deficiency in the age group of years old, was higher than in age group of >30 years old, due to the zinc increasing request in younger women because of their growth. In different fetus age, there was a significant change due to the maternal zinc requests. Pregnant women resulting with zinc level <70µg/dL were marked as zinc deficient patients, whereas those with zinc level >70µg/dL as normal patients. Serum zinc levels in 17 cases (34%) was in normal range (>70µg/dL), whereas in 33 cases (66%) was below normal range (<70µg/dL). Without an adequate nutritional request, the person may fall in zinc deficiency condition. Keywords: zinc and pregnancy, zinc normal values, serum zinc levels, zinc determination. INTRODUCTION Micronutrients and trace elements have an important influence on the health of both mother and fetus. Deficiency of micronutrients during pregnancy may give rise to complications such as anemia and hypertension, as well as impairing fetal function, development and growth. Serum zinc level in pregnant women, needs more investigation, because its deficiency may cause severe anomalies of the fetus. Zinc is an essential trace element for humans, animals and plants. It is necessary for the functioning of more than 300 different enzymes, which means it plays a role in a great number of bodily activities. Some of those activities are critical during pregnancy, because they involve embryo and fetal development as well as infant growth (1). Zinc is found in all parts of the body: it is in organs, tissues, bones, fluids and cells. The adult body contains about 2-3 grams of zinc. Muscles and bones contain most of the body s zinc (90%). Although humans can handle proportionally large concentrations of zinc, too much zinc can still cause eminent health problems, such as stomach cramps, skin irritations, vomiting, nausea and anemia. Very high levels of zinc can damage the pancreas and also disturb the protein metabolism. Zinc - vital for growth and cell division: Zinc is especially important during pregnancy, for the growing fetus whose cells are rapidly dividing. Zinc also helps to avoid congenital abnormalities and pre-term delivery. Zinc is vital in activating growth - height, weight and bone development - in infants, children and teenagers. Zinc vital for the immune system: Among all the vitamins and minerals, zinc shows the strongest effect on our all-important immune system. Zinc plays a unique role in the T-cells. Low zinc levels lead to reduced and weakened T-cells which are not able to recognize and fight off certain infections. > RJSITM: Volume: 02, Number: 02, December-2012 Page 29

2 An increase of the zinc level has proven effective in fighting pneumonia and diarrhea and other infections. Zinc can also reduce the duration and severity of a common cold. Zinc vital for taste, smell and appetite: Zinc activates areas of the brain that receive and process information from taste and smell sensors. Levels of zinc in plasma and zinc s effect on other nutrients, like copper and manganese, influence appetite and taste preference. Zinc is also used in the treatment of anorexia. MATERIAL AND METHODS The techniques used for the determination of serum zinc, include Colorimetry, Polarography, X-ray fluorescence, Fluorometry and Atomic Absorption Spectroscopy (AAS). AAS techniques are preferred in the clinical laboratory, because of their specificity, sensitivity, precision, simplicity, and relatively low cost per analysis. The measurement of serum zinc is used to assess the status of zinc metabolism in humans. The direct dilution method presented here requires less than 2 min per sample. We used Glycerol as a solvent for the standards, and it also serves as an ideal additive for adjusting the viscosity and flow rate of the standards (2,3). For this study we took into consideration 50 cases of pregnant women, including anemic and non anemic (normal) pregnancies, who served as control group. We divided mothers according to maternal age to three groups, group 1 (<20 years), group 2 (20-30 years) and group 3 (>30 years), according to fetus age to three groups, group 1 (first trimester of pregnancy), group 2 (second trimester of pregnancy) and group 3 (third trimester of pregnancy). We also divided mothers according to number of deliveries to four groups, group 1 (1 deliveries), group 2 (2 deliveries), group 3 (3 deliveries) and group 4 (>3 deliveries), according to maternal diagnosis (preterm delivery, abortion, anomalies etc) and according to hemoglobin level (4,5). We took 2 ml blood from each pregnant woman and serum zinc level was measured directly by using Atomic Absorption Spectrometry (VARIAN AAS-220). These specimens were measured at the same time using Colorimetry (End-Point), in a way that we could compare the results. Those pregnant women having zinc concentration less than 70 mcg/dl were marked as zinc deficient patients. Tab 1. Zinc distribution according to maternal age Maternal age Zn<70 mcg/dl % Zn>70mcg/dl % Total < 20 years old years old > 30 years old Tab 2. Zinc distribution according to fetus age Fetus age Zn<70 mcg/dl % Zn>70mcg/dl % Total First trimester Second trimester Third trimester > RJSITM: Volume: 02, Number: 02, December-2012 Page 30

3 Tab 3. Zinc distribution according to number of deliveries Number of diliveries Zn<70 mcg/dl % Zn>70mcg/dl % Total 1 delivery deliveries deliveries >3 deliveries Tab 4. Zinc distribution according to maternal diagnosis Maternal diagnosis Zn<70 mcg/dl % Zn>70mcg/dl % Total Preterm delivery Twin pregnancy Hyperemesis Cephalic Abortion Podalic Anomalies Rupture membranes Placenta previa Phetal Hypotrphy Pre-eclampsia Tab 5. : Zinc distribution according to hemoglobin Hemoglobin Zn<70 mcg/dl % Zn>70mcg/dl % Total Hb < Hb: RESULTS AND DISCUSSION Mothers more than 30 years had lower zinc deficiency than mothers in age group of years. This may be due to higher requirement of zinc for younger age due to their growth age. The prevalence of zinc deficiency in the different age of pregnancy showed a meaningful difference (higher in the third trimester of pregnancy in comparison to the first and the second trimester) and that was due to mothers increasing requirement for zinc. A data processing was done by two methods, Descriptive Statistics and Anova: Single Factor for the comparison of the results. Descriptive Statistics Zinc measurement with Colorimetry Zinc measurement with AAS Mean Mean Standard Error Standard Error Median 53 Median Mode 108 Mode > RJSITM: Volume: 02, Number: 02, December-2012 Page 31

4 Zinc values Standard Deviation Standard Deviation Sample Variance Sample Variance Minimum 24 Minimum 24 Maximum 112 Maximum 112 Sum Sum Count 50 Count 50 Confidence Level(95.0%) Confidence Level(95.0%) Anova: Single Factor SUMMARY Groups Count Sum Average Variance Column Column ANOVA Source of Variation SS df MS F P-value F crit E Between Groups Within Groups Total From the values of serum zinc, taken from normal pregnant women and those suffering from anemia, we built a chart to see clearly the results. It is as follows: 120 Zinc measurement with two different methods CONCLUSIONS Number of pregnant women Zinc measurement with Colorimetry Zinc measurement with AAS According to this statistical data processing (P= 0.99) and as seen from the graph, serum zinc values, measured with both methods, showed the same curve, so that there was no significant change in the results measured by these two methods. > RJSITM: Volume: 02, Number: 02, December-2012 Page 32

5 The most frequent diagnosis was the cephalic one, preeclampsia and also preterm delivery. Mothers more than 30 years had lower zinc deficiency than mothers in age group of years. This may be due to higher requirement of zinc for younger age due to their growth age. Statistical analysis indicated that zinc deficiency had a positive correlation with mother age and term of pregnancy, but no correlation with number of deliveries. Zinc is a useful microelement during pregnancy. Serial zinc level was lower in pregnant women suffering from anemia, than in normal pregnant women (serving as a control group). Pregnant women having zinc concentration less than 70 µg/dl were marked as zinc deficient. The serum zinc level in 17 individuals (34%) was on the normal range, in 33 patients (66%) was less than normal. In this study the prevalence of zinc deficiency in pregnant women was about 66%. RECOMMENDATIONS Without a proper nutritional requirement the person falls in the state of zinc deficiency Zinc prophylactic treatment is important before and during pregnancy. Everyone needs zinc. Children need zinc to grow, adults need zinc for health. Growing infants, children and adolescents, pregnant women and lactating mothers, athletes, vegetarians and the elderly often require more zinc (6,7). REFERENCES 1. Keillin D. Mann J. Carbonic Anhydrase, purification and nature of the enzyme. Bio-Chem 34: ; Prasad AS, Oberleas D. Changes in activity of zinc dependent enzymes in zinc deficient tissues of rats. J Appl Physiol 31: , MiKac-Devic, D.Methodology of zinc determinations and the role of zinc in biochemical processes. Ado. Clin. Chem. 13, , Dawson, J. B., and Walker, B. E Direct determination of zinc in whole blood, plasma and urine by atomic absorption spectroscopy. Clin. Chim. Acta 26, , (1969). 5. Sprague, S., and Slavin, W. Determination of iron, copper, and zinc in blood serum by an atomic absorption method requiring only dilution. At. Absorp. Newslett. 4, , Kiilerich S, Christiansen C, Christensen MS, Naestoft J. Zinc metabolism in patients with chronic renal failure during treatment with 1,25-dihydroxycholecalciferol: a controlled therapeutic trial. Clin Nephrol 15: 23-27, Wolman SLI, Anderson H, Marliss EB, Jeebhoy KN. Zinc in total parenteral nutrition requirement and metabolic effects. Gastroenterology 76: , > RJSITM: Volume: 02, Number: 02, December-2012 Page 33