Maternal zinc, iron, folic acid, and protein nutriture and outcome of human pregnancy

Abstract

Four hundred fifty women were observed during pregnancy and postpartum. Forty-three variables including 12 laboratory indices of maternal nutrient status were assessed. Of the variance in fetal weight and head circumference 9.9 and 8.1%, respectively, were predictable by polynomial stepwise regression of laboratory indices of maternal nutriture. Maternal plasma zinc levels were inversely correlated with fetal weight. The occurrence of pregnancy complications in the highest and lowest quartiles of maternal plasma zinc, albumin, iron, and folic acid were compared. Using data only from the initial blood samples for which the trimester was identified precisely (n = 394), a significant association was found between the total occurrence of fetomaternal complications and zinc and albumin levels in the lowest quartile (zinc, p < 0.02; albumin, p < 0.02). Low zinc or low albumin were also associated with the specific complications of fetal distress (zinc, p < 0.002; albumin p < 0.002). High plasma folate was also associated with the total occurrence of complications (p < 0.008) and with fetal distress (p < 0.002). When all data (n = 713) including repeat blood samples and data from 56 mothers in whom the trimester could not be verified precisely were evaluated, associations between other complications and lowest quartile zinc and albumin and highest quartile folate were identified. Discriminant analysis of data from the initial blood samples revealed that plasma zinc was a discriminator for fetomaternal complications only in women in the lowest quartile for plasma zinc.