Relationship between pre-pregnancy body mass index and mineral concentrations in serum and amniotic fluid in pregnant women during labor

https://doi.org/10.1016/j.jtemb.2018.12.007Get rights and content

Highlights

  • Obesity is related with low iron status and high load serum concentration in pregnant women.

  • An excessive body weight in pregnant women favors high level of lead in the serum during labor.

  • Verification of current recommendation for minerals intake in pregnant women need to be justified.

Abstract

The aim of the study was to determine the correlations between body mass index (BMI) values before pregnancy and the concentrations of selected elements (Mg, Co, Cu, Zn, Sr, Cd, Ba, Pb, U, Ca, Cr, Al, Mn, V, Fe) in blood serum and amniotic fluid (AF) in pregnant women. Elemental analysis of serum and amniotic fluid in 225 Polish women (Caucasian/white) showed a relationship between the concentration of minerals in the above-mentioned samples and the pre-pregnancy BMI. Analysis of blood serum was performed by using ICP-MS and it demonstrated that iron concentration was significantly lower in overweight and obese women. Being underweight in pregnant women was associated with a significantly lower concentration of magnesium and cobalt in the blood serum. Both underweight and overweight women were associated with significantly lower concentrations of calcium and strontium in the blood serum. The concentration of cobalt was significantly higher in underweight women. The concentration of lead in the blood serum of overweight and obese women was significantly higher than in other groups. Analysis of the AF showed that the concentration of copper was significantly lower in overweight and obese women, and the concentration of manganese and vanadium significantly higher than in other groups of women. A deficiency in essential minerals and an excess of heavy metals in women may be associated with abnormal body weight and this is important in the etiopathogenesis of pregnancy and fetal development disorders.

Introduction

Both excessive body weight and being underweight in pregnant women are associated with numerous disturbances in the course of pregnancy and fetal development [[1], [2], [3], [4]]. Obesity in pregnancy may be the cause of gestational diabetes, hypertension and pre-eclampsia. In addition, miscarriage and birth by cesarean section are more frequent in women with a high body mass index (BMI) [[1], [2], [3], [4]]. Both overly low and overly high body weight in pregnant women pose a risk of premature labor [4]. Moreover, fetal growth disorders of the LGA (large for gestational age) and SGA (small for gestational age) type and higher rates of morbidity and mortality among newborns are more likely to be found in women with abnormal body weight [[4], [5], [6]].

Body weight disorders are largely due to improper nutritional habits. In women of childbearing age and pregnant women, a low dietary supply of iron, calcium, zinc, iodine and magnesium is often observed [[7], [8], [9], [10], [11], [12]].

Deficiencies in essential minerals in women are often associated with abnormal body weight and may be important in the etiopathogenesis of pregnancy and fetal development disorders [[13], [14], [15]]. Minerals, being a part of numerous compounds with regulatory activity such as enzymes and hormones, play an important role in the division and differentiation of fetal cells and in their further development. Mineral deficiencies in pregnant women correlate with congenital fetal defects and growth disorders [16,17]. Overweight and obese pregnant women who also use a high-energy diet low in micronutrients may be at higher risk of mineral deficiencies [[18], [19], [20]].

A low concentration of iron, zinc, manganese and copper in the body of a pregnant woman may contribute to fetal growth disorders, and development of pre-eclampsia and anemia in both the mother and the child [[7], [8], [9], [10],21]. Low serum iron concentration in pregnant women also correlates with the occurrence of neurodevelopmental disorders in infants [22]. Similarly, studies involving children from obese pregnant women have demonstrated a relationship between maternal obesity and the occurrence of neurological disorders in children [23]. An increased concentration of selenium and copper in the umbilical cord blood serum may be associated with the occurrence of lipid metabolism disorders in infants [24].

Zinc, selenium, manganese, and copper are a key element of the complex enzymatic systems responsible for the antioxidant protection of the organism. A relationship has been found between the occurrence of obesity in pregnant women and increased oxidative stress and decreased antioxidant activity in placental tissue [25]. Antioxidant function of minerals seems to be particularly important during pregnancy, which is physiologically associated with a greater intensity of oxidation reactions [26,27]. Being overweight and obese when pregnant constitutes an additional factor intensifying the mentioned processes. The literature data show a relationship between the decreased concentration of mineral components with antioxidant activity in the body of pregnant women and an increased risk of hypertension, gestational diabetes as well as pre-eclampsia and miscarriage [[28], [29], [30]].

The aim of this study was to determine the relationship between BMI before pregnancy and the concentration of selected mineral components in the blood serum and AF of pregnant women.

Section snippets

Materials and methods

The study protocol was approved by the Local Ethics Committee of the Polish Mother’s Memorial Hospital Research Institute in Łódź, Poland (approval no. 50/2016). This study was conducted in accordance with the Declaration of Helsinki.

Results

Table 1 presents maternal parameters related to the pre-pregnancy BMI. Analysis of the pre-pregnancy body weight of women and their body weight before the birth showed a relationship between these parameters. The body weight of women both before the pregnancy and before the birth was the highest in group 3 and the lowest in group 1.

The average weight gain during pregnancy in the group of women with normal body weight (group 2) and women who were overweight or obese (group 3) presented similar

Discussion

Few studies have investigated the subject of an extended analysis of element concentrations in the body of pregnant women in relation to their body weight. The most numerous are studies on iron concentration [[32], [33], [34]]. In our study, it was observed that being overweight or obese in pre-pregnancy women was associated with significantly lower serum iron levels. Some studies indicate disturbed iron homeostasis in obesity [35]. The research results described so far are consistent with the

Conclusions

Being overweight and obesity in women before and during pregnancy is associated with low concentrations of minerals important for fetal development and pregnancy course, including iron, calcium and copper. In addition, an excessive body weight favors high levels of lead in the body, which may threaten the health of the mother and the fetus. Therefore, obese women of reproductive age as well as obese pregnant women should be included in the nutritional and health education program. Verification

Ethics

Study has been approved by the Local Ethics Committee of the Polish Mother’s Memorial Hospital Research Institute in Łódź, Poland (approval no. 50/2016) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All subjects gave their written informed consent prior to their inclusion in the study.

Funding

This study was supported by the Polish Ministry of Science & Higher Education for Polish Mother's Memorial Hospital Research Institute in Łódź (Grant No. 2016/I/18-GW). The funding source had no involvement in the study design, in the collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the article for publication.

Declarations of interest

None

Acknowledgment

We want to thank Translmed Publishing Group (TPG) for English editing service.

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    Both authors contributed equally to this work.

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