First Trimester Serum Copper or Zinc Levels, and Risk of Pregnancy-Induced Hypertension

Nutrients. 2019 Oct 16;11(10):2479. doi: 10.3390/nu11102479.


Early identification of women at risk of developing pregnancy-induced hypertension (PIH) is very important. The involvement of copper (Cu) and zinc (Zn) in the oxidative balance suggests the possibility of their association with this disease, in which oxidative stress plays a key role. However, it has not been established so far whether the microelement levels in early pregnancy may be risk markers of the disease, as prospective studies are limited in number. In our innovative single-center study, we identified from a prospective cohort of healthy women in the 10-14th week of a single pregnancy: women subsequently developing pregnancy-induced hypertension (n = 121) and matched women remaining normotensive (n = 363). We measured the concentrations of microelements in the serum from 10-14 week, using the inductively coupled plasma mass spectrometry (ICP-MS). The odds ratios of the disease (and 95% confidence intervals) were assessed in logistic regression. In the whole cohort, the odds ratio (OR) of PIH was 1.52 (p = 0.174) for women in the lowest (Q1) quartile of Cu (≤1540.58 µg/L) compared with women in the highest (Q4) quartile (>1937.46 µg/L), but adjusted odds ratio (AOR) was 2.17 (p = 0.019) after adjusted for pre-pregnancy body mass index (BMI) and gestational age at recruitment. The higher levels of Cu in the subgroup of BMI ≥ 25 kg/m2 compared to normal BMI were found (1847.64 vs. 1673.36 µg/L; p < 0.0001). In the subgroup of women with the normal pre-pregnancy BMI, the adjusted odds ratio of PIH was AOR = 2.95 (p = 0.040) for Q1 vs. Q4 quartile. Our results suggest that lower Cu levels in early pregnancy may be connected with higher risk of PIH, but BMI affected estimated odds ratios. Zinc levels had no effect on the risk.

Keywords: BMI; copper; hypertension; microelement; pregnancy; risk; smoking; trace elements; zinc.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Body Mass Index
  • Case-Control Studies
  • Copper / blood*
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced / blood
  • Hypertension, Pregnancy-Induced / diagnosis
  • Hypertension, Pregnancy-Induced / etiology*
  • Middle Aged
  • Pregnancy
  • Pregnancy Trimester, First / blood
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / blood
  • Young Adult
  • Zinc / blood*


  • Biomarkers
  • Copper
  • Zinc