SERUM LEVELS OF SELECT MICRONUTRIENTS IN PRIMIGRAVIDA WITH PREECLAMPSIA VERSUS THEIR NORMOTENSIVE COUNTERPARTS: A CASE CONTROL STUDY AT A TERTIARY TEACHING HOSPITAL IN KENYA.

Abstract

Background: Preeclampsia (PE) is a one of the leading causes of maternal mortality as well as morbidity and long-term disability to mothers and newborns in sub-Saharan Africa. Various micronutrients have been implicated in its pathophysiology. Supplementation of some of these micronutrients, like calcium being recommended as part of the preventive strategies of PE in resource-poor countries. The status of these micronutrients and their relationship with PE vary from population to population. 
 Objective: To investigate the serum levels of select micronutrients (Vitamin D, calcium, zinc, and selenium) in preeclamptic and normotensive primigravid women in a tertiary teaching hospital in Kenya. 
 Methods: This was a case-control study. Primigravid controls matched for age and gestation with those with preeclampsia were included in the study. Data on their demographic and obstetric, nutritional were obtained. They were interviewed on frequency of consumption of specific nutrient rich foods. Blood samples were obtained for serum analysis of Vitamin D, Calcium, Selenium and Zinc levels. 
 Results: 108 participants were included. There were no significant differences in age, educational level and income level between the two study groups. Mean serum calcium and Vitamin D levels were significantly lower among the participants with preeclampsia. The mean serum vitamin D level amongst cases and controls was 20.8±10.2 ng/ml and 28.6±7.9 ng/ml respectively (p<0.001) while the serum calcium levels were 2.2±0.3mmol/l for the cases and 2.3±0.09mmol/l for the controls (p=0.024). There was no statistically significant association between serum levels of Selenium and Zinc with preeclampsia. Most of the controls consumed diets rich in calcium in comparison to the cases. The controls were more likely to consume fish, one of the dietary sources of Vitamin D, compared to the cases. There were no differences in consumption of foods rich in zinc and selenium. 
 Conclusion: Pregnant women with preeclampsia have lower serum levels of calcium and vitamin D compared to their normotensive counterparts.