The Effect of Maternal Trace Element Status (Copper, Zinc, Selenium, and Chromium) on Neonatal Wellbeing

Saja Karim Toman; Majid Hameed Ahmed; Shaimaa Abdulamir Nasir

doi:10.61132/obat.v3i5.1698

Authors

Saja Karim Toman Al-Diwaniyah Health Directorate
Majid Hameed Ahmed Al-Nahrain University
Shaimaa Abdulamir Nasir Al-Qadisiyah University

DOI:

https://doi.org/10.61132/obat.v3i5.1698

Keywords:

APGAR score, Chromium, Copper, Selenium, Zinc

Abstract

Trace elements such as copper, zinc, selenium, and chromium play essential roles in various enzymatic reactions, antioxidant defense mechanisms, and overall metabolic regulation, making them crucial for maternal and fetal health. During pregnancy, the demand for these micronutrients increases significantly due to physiological changes and the needs of the developing fetus. Inadequate or excessive levels of these trace elements can lead to altered fetal development and may impact neonatal outcomes immediately after birth. Given the sensitive developmental window of gestation, the intrauterine environment—including micronutrient status—has been hypothesized to influence neonatal physiological parameters such as heart rate, respiratory rate, and Apgar scores, which are commonly used to assess neonatal wellbeing in the early minutes of life. This study attempts to explore the impact of maternal trace element status—specifically copper, zinc, selenium, and chromium—along with selected maternal parameters (BMI, parity, gravida) on indicators of neonatal wellbeing, including heart rate, respiratory rate, and 5-minute Apgar score. A cross-sectional study was conducted in the Delivery Room of the Obstetric Hospital in Al-Diwaniya City, Iraq, involving 50 mother-infant pairs. Data collection occurred from December 1, 2024, to February 10, 2025. Maternal blood samples were analyzed using atomic absorption spectrophotometry to determine serum concentrations of copper, zinc, selenium, and chromium. Neonatal outcomes were assessed via standard clinical evaluations: heart rate and respiratory rate were measured immediately postpartum, and Apgar scores were recorded at five minutes. Statistical analyses included Pearson correlation and multiple linear regression to assess associations between maternal factors and neonatal outcomes. Bivariate and multivariate analyses indicated limited but noteworthy associations. Maternal serum chromium levels were significantly associated with increased neonatal respiratory rate (p = 0.026), suggesting a possible stimulatory or stress-related effect.

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References

Abdel Mageed, A. B., Welti, R., Oehme, F. W., & Pickrell, J. A. (1994). Perinatal hypocuprosis affects synthesis and composition of neonatal lung collagen, elastin, and surfactant. American Journal of Physiology, 267(6 Pt 1), L679–L685. https://doi.org/10.1152/ajplung.1994.267.6.L679

Anderson, R. A. (1981). Nutritional role of chromium. Science of the Total Environment, 17(1), 13–29. https://doi.org/10.1016/0048-9697(81)90104-2

Arthur, J. R., McKenzie, R. C., & Beckett, G. J. (2003). Selenium in the immune system. The Journal of Nutrition, 133(5 Suppl 1), 1457S–1459S. https://doi.org/10.1093/jn/133.5.1457S

Avery, J. C., & Hoffmann, P. R. (2018). Selenium, selenoproteins, and immunity. Nutrients, 10(9), 1203. https://doi.org/10.3390/nu10091203

Banu, S. K., Stanley, J. A., Taylor, R. J., Sivakumar, K. K., Arosh, J. A., Zeng, L., Pennathur, S., & Padmanabhan, V. (2018). Sexually dimorphic impact of chromium accumulation on human placental oxidative stress and apoptosis. Toxicological Sciences, 161(2), 375–387. https://doi.org/10.1093/toxsci/kfx224

Barman, M., Brantsæter, A. L., Nilsson, S., Haugen, M., Lundh, T., Combs, G. F., Zhang, G., Muglia, L. J., Meltzer, H. M., Jacobsson, B., & Sengpiel, V. (2020). Maternal dietary selenium intake is associated with increased gestational length and decreased risk of preterm delivery. British Journal of Nutrition, 123(2), 209–219. https://doi.org/10.1017/S0007114519002113

Daniel, W. W., & Cross, C. L. (2013). Biostatistics: A foundation for analysis in the health sciences (10th ed.). Wiley.

Değer, U., Turan, G., & Peker, N. (2022). Is there any connection between zinc deficiency and poor obstetric outcomes in pregnancy? Journal of Gynecology & Obstetrics, 19(3), 1424–1430.

Gathwala, G., & Yadav, O. P. (2002). Selenium in the neonate. Indian Journal of Pediatrics, 69(5), 443–446. https://doi.org/10.1007/BF02722640

Goldhaber, S. B. (2003). Trace element risk assessment: Essentiality vs. toxicity. Regulatory Toxicology and Pharmacology, 38(2), 232–242. https://doi.org/10.1016/S0273-2300(02)00020-X

Hellman, N. E., & Gitlin, J. D. (2002). Ceruloplasmin metabolism and function. Annual Review of Nutrition, 22, 439–458. https://doi.org/10.1146/annurev.nutr.22.012502.114457

Hu, H., Liu, Z., Li, J., Li, S., Tian, X., Lin, Y., Chen, X., Yang, J., Deng, Y., Li, N., Wang, Y., Yuan, P., Li, X., & Zhu, J. (2014). Correlation between congenital heart defects and maternal copper and zinc concentrations. Birth Defects Research Part A: Clinical and Molecular Teratology, 100(12), 965–972. https://doi.org/10.1002/bdra.23284

Johnson, J. K., Harris, F. L., Ping, X. D., Gauthier, T. W., & Brown, L. A. S. (2019). Role of zinc insufficiency in fetal alveolar macrophage dysfunction and RSV exacerbation associated with fetal ethanol exposure. Alcohol, 80, 5–16. https://doi.org/10.1016/j.alcohol.2018.11.007

Khadem, N., Mohammadzadeh, A., Farhat, A. S., Valaee, L., Khajedaluee, M., & Parizadeh, S. M. (2012). Relationship between low birth weight neonate and maternal serum zinc concentration. Iran Red Crescent Medical Journal, 14(4), 240–244.

Köhrle, J., & Gärtner, R. (2009). Selenium and thyroid. Best Practice & Research: Clinical Endocrinology & Metabolism, 23(6), 815–827. https://doi.org/10.1016/j.beem.2009.08.002

Kotaś, J., & Stasicka, Z. (2000). Chromium occurrence in the environment and methods of its speciation. Environmental Pollution, 107(3), 263–283. https://doi.org/10.1016/S0269-7491(99)00168-2

Krebs, N. F., Belfort, M. B., Meier, P. P., Mennella, J. A., O’Connor, D. L., Taylor, S. N., & Raiten, D. J. (2023). Infant factors that impact the ecology of human milk secretion and composition—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 3. American Journal of Clinical Nutrition, 117(Suppl 1), S43–S60. https://doi.org/10.1016/j.ajcnut.2023.01.021

Lukaski, H. C. (1999). Chromium as a supplement. Annual Review of Nutrition, 19, 279–302. https://doi.org/10.1146/annurev.nutr.19.1.279

Makhoul, I. R., Sammour, R. N., Diamond, E., Shohat, I., Tamir, A., & Shamir, R. (2004). Selenium concentrations in maternal and umbilical cord blood at 24–42 weeks of gestation: Basis for optimization of selenium supplementation to premature infants. Clinical Nutrition, 23(3), 373–381. https://doi.org/10.1016/j.clnu.2003.08.004

Merialdi, M., Caulfield, L. E., Zavaleta, N., Figueroa, A., & DiPietro, J. A. (1999). Adding zinc to prenatal iron and folate tablets improves fetal neurobehavioral development. American Journal of Obstetrics and Gynecology, 180(2 Pt 1), 483–490. https://doi.org/10.1016/S0002-9378(99)70236-X

Mertz, W. (1969). Chromium occurrence and function in biological systems. Physiological Reviews, 49(2), 163–239. https://doi.org/10.1152/physrev.1969.49.2.163

Pan, X., Hu, J., Xia, W., Zhang, B., Liu, W., Zhang, C., Yang, J., Hu, C., Zhou, A., Chen, Z., Cao, J., Zhang, Y., Wang, Y., Huang, Z., Lv, B., Song, R., Zhang, J., Xu, S., & Li, Y. (2017). Prenatal chromium exposure and risk of preterm birth: A cohort study in Hubei, China. Scientific Reports, 7(1), 3048. https://doi.org/10.1038/s41598-017-03106-z

Pan, Z., Zhu, T., Zhu, J., & Zhang, N. (2022). Association between maternal selenium exposure and congenital heart defects in offspring: A systematic review and meta analysis. Iranian Journal of Public Health, 51(10), 2149–2158. https://doi.org/10.18502/ijph.v51i10.10974

Pieczyńska, J., Płaczkowska, S., Sozański, R., & Grajeta, H. (2024). Is maternal selenium status associated with pregnancy outcomes in physiological and complicated pregnancy? Nutrients, 16(17), 2873. https://doi.org/10.38136/jgon.1117596

Prasad, A. S. (2009). Impact of the discovery of human zinc deficiency on health. Journal of the American College of Nutrition, 28(3), 257–265. https://doi.org/10.1080/07315724.2009.10719780

Rayman, M. P. (2012). Selenium and human health. Lancet, 379(9822), 1256–1268. https://doi.org/10.1016/S0140-6736(11)61452-9

Sann, L., Rigal, D., Galy, G., Bienvenu, F., & Bourgeois, J. (1980). Serum copper and zinc concentration in premature and small for date infants. Pediatric Research, 14(9), 1040–1046. https://doi.org/10.1203/00006450-198009000-00005

Sarricolea, M. L., Villa Elízaga, I., & Lopez, J. (1993). Respiratory distress syndrome in copper deficiency: An experimental model developed in rats. Biology of the Neonate, 63(1), 14–25. https://doi.org/10.1159/000243903

Sherlock, L. G., McCarthy, W. C., Grayck, M. R., Solar, M., Hernandez, A., Zheng, L., Delaney, C., Tipple, T. E., Wright, C. J., & Nozik, E. S. (2022). Neonatal selenium deficiency decreases selenoproteins in the lung and impairs pulmonary alveolar development. Antioxidants, 11(12), 2417. https://doi.org/10.3390/antiox11122417

Solé Navais, P., Brantsæter, A. L., Caspersen, I. H., Lundh, T., Muglia, L. J., Meltzer, H. M., Zhang, G., Jacobsson, B., & Sengpiel, V., & Barman, M. (2020). Maternal dietary selenium intake during pregnancy is associated with higher birth weight and lower risk of small for gestational age births in the Norwegian Mother, Father and Child Cohort Study. Nutrients, 13(1), 23. https://doi.org/10.3390/nu13010023

Thompson, J. (2018). Nutrition: An applied approach. Pearson.

Wang, L., Yu, T., Liu, Y., Fan, X., Song, W., & Zhao, C. (2023). The association between maternal iron, zinc, copper levels in serum and pregnancy outcomes. Journal of Obstetrics and Gynaecology Research, 49(8), 2056–2062. https://doi.org/10.1111/jog.15705

Xia, W., Hu, J., Zhang, B., Li, Y., Wise, J. P., Bassig, B. A., Zhou, A., Savitz, D. A., Xiong, C., Zhao, J., du, X., Zhou, Y., Pan, X., Yang, J., Wu, C., Jiang, M., Peng, Y., Qian, Z., Zheng, T., & Xu, S. (2016). A case control study of maternal exposure to chromium and infant low birth weight in China. Chemosphere, 144, 1484–1489. https://doi.org/10.1016/j.chemosphere.2015.10.006

Yazar, H., Yuvacı, H. U., & Elmas, B. (2023). Role of copper and zinc in full-term pregnancy and its effect on Apgar score. Asian Journal of Research in Biochemistry, 12(1), 16–22. https://doi.org/10.9734/AJRB/2023/v12i1225

Ziaee, H., Daniel, J., Datta, A. K., Blunt, S., & McMinn, D. J. (2007). Transplacental transfer of cobalt and chromium in patients with metal-on-metal hip arthroplasty: A controlled study. The Journal of Bone and Joint Surgery. British Volume, 89(3), 301–305. https://doi.org/10.1302/0301-620X.89B3.18520