The effect of maternal smoking on the relationship between maternal and fetal zinc status and infant birth weight.

Smoking alters the relationship between maternal zinc intake and biochemical indices of fetal zinc status

Zinc status, pregnancy complications, and labor abnormalities

Red blood cell metallothionein as an indicator of zinc status during pregnancy

Breast milk provides adequate nutrients during the first 6 months of life. However, there are some reports of zinc deficiency in breastfed infants. This study was conducted to determine the prevalence of zinc deficiency in infants aged 4-6 months and the associated factors. Healthy infants aged 4-6 months and their mothers were enrolled. They were classified by feeding types as breastfed (BF), formula-fed (FF), and mixed groups (MF). Data collection included demographic data, perinatal data, given diets, and anthropometric measurement. Blood from infants and lactating mothers, and breast milk samples were collected to assess plasma and breast milk zinc concentrations. From 158 infants, the prevalence of zinc deficiency (plasma level below 10.7 mol/L) was 7.6%, and according to feeding groups 14.9%, 5.3%, and 2.9% in the BF, the FF, and the MF groups, respectively. Breastfed infants with zinc deficiency had significantly lower maternal zinc concentrations compared with those without zinc deficiency. There was a higher proportion of maternal zinc deficiency in zinc-deficient infants than those without zinc deficiency (66.7% vs 16.2%, p=0.02). There was a positive correlation between zinc concentrations in breast milk and plasma zinc concentrations of infants (r=0.62, p=0.01) and plasma zinc concentrations of lactating mothers (r=0.56, p=0.016). Using the regression analysis, infant zinc status was associated with maternal plasma zinc concentrations among breastfed infants. The results of this study suggest that breastfed infants aged 4-6 months may have a risk of zinc deficiency and that risk is associated with maternal zinc status and breast milk zinc concentrations.

Background/Objectives: Zinc deficiency remains a public health concern in South Asia but is rarely studied through gestation to infancy. Methods: We identified maternal and infant factors related to plasma zinc of 3 mo old Bangladeshi infants (n = 317) in the context of a trial of a daily antenatal to 3 mo postpartum multiple micronutrient supplementation (MMS) with 15 vitamins and minerals, including 12 mg zinc, versus iron–folic acid (IFA). Factors explored included maternal age, parity, and plasma zinc in early (pre-supplementation) and late pregnancy, at 3 months postpartum, and in milk; cord blood zinc (n = 83); birth outcomes; and infant feeding and biomarkers. Consequently, infant zinc was explored with 3 mo anthropometry and growth rates. Results: Mean ± SD infant plasma zinc was 15.63 ± 6.65 µmol/L, with 10.1% deficiency (<9.9 µmol/L). In adjusted analyses, infant zinc was positively associated with maternal age [20–30 years +0.11 µmol/L (p = 0.018) and ≥30 years +0.28 µmol/L (p = 0.003) relative to <20 years], maternal early pregnancy zinc (+0.01 µmol/L per 1 µmol/L maternal zinc, p = 0.011), and infant ferritin (+0.001 µmol/L per 1 µg/L, p = 0.007); conversely, infant zinc was −0.13 µmol/L lower (p = 0.013) with maternal parity ≥2 versus 0–1 and with partial versus exclusive breastfeeding (−0.15 µmol/L, p = 0.038). Relationships with MMS, maternal later pregnancy, postpartum, milk, and cord blood zinc were absent. Length-for-age (+0.02 per µmol/L, p = 0.047) but not weight-for-length Z-scores at 3 months were associated with infant zinc. Conclusions: Thus, infant zinc was associated with pre- but not post-MMS maternal zinc, age and parity, feeding style, and infant iron status. Infant length but not weight was associated with plasma zinc.

Adding zinc to prenatal iron and folate supplements improves maternal and neonatal zinc status in a Peruvian population

ABSTRACT. A 3-month-old premature breast fed infant developed symptomatic zinc deficiency manifested by rash identical to that of acrodermatitis enteropathica, diarrhoea, irritability and poor weight gain. Deficient maternal breast milk zinc secretion was demonstrated. This was not related to maternal dietary zinc deficiency and was associated with normal maternal plasma zinc levels. No change in maternal plasma or breast milk zinc occurred with maternal zinc supplementation, suggesting that the aetiology of the low breast milk zinc was a primary defect in mammary gland zinc secretion. A rapid clinical response and return of plasma zinc to normal occurred with oral zinc treatment. Zinc therapy was ceased at 9 months of age without recurrence of symptoms or hypozincaemia. Four similar infants have been reported previously suggesting a common pathogenesis.

Plasma and red blood cell zinc in cystic fibrosis.

Objectives: Zinc is an essential trace element that serves as a cofactor for many metalloenzymes. Zinc deficiency is prevalent in South Asia, contributing to adverse maternal, birth, and offspring outcomes. We measured plasma zinc of 3-month-old infants in rural Bangladesh at the conclusion of a trial of a zinc-containing antenatal multiple micronutrient supplement (MMS) versus iron-folic acid (IFA) supplement to identify characteristics associated with infant zinc status. Methods: Within a cluster-randomized trial of antenatal (early pregnancy through 3 months postpartum) MMS, including 12 mg zinc, versus IFA, associations of infant zinc with maternal characteristics were examined in n=317 3-month-olds, a subset from mother-infant pairs in whom maternal zinc was measured in pregnancy and postpartum. The MMS versus IFA effect on zinc was tested by t-test, and multivariable generalized linear regression was used to examine associations with maternal factors, accounting for cluster. Results: There was no effect of MMS on infant zinc (p=0.56), which averaged 15.34 ± 0.36 μmol/L with 10.4% < 9.95 μmol/L, a cutoff for deficiency. Corresponding maternal plasma zinc in early pregnancy (pre-supplementation) was 11.00 ± 0.14 μmol/L, with 30.3% deficient. In adjusted analysis, infant zinc was associated with maternal early pregnancy but not late pregnancy, postpartum, or milk zinc, increasing 0.26 [95% CI: 0.03, 0.48] μmol/L per 1 μmol/L increment in maternal early pregnancy zinc (p=0.03). Infant zinc was 4.40 [0.15, 8.65] μmol/L higher among mothers >30 compared to < 20 years (p=0.04); conversely, parity of 1-3 was associated with 2.87 [-5.60, -0.13] μmol/L lower infant zinc compared to parity 0 (p=0.04). Conclusions: Infant zinc was also associated with non-modifiable maternal factors—that is, positively with age but inversely with parity. Infant zinc deficiency was present, although less common than among mothers, and findings suggest challenges in improving infant zinc status through maternal interventions during and after pregnancy. Further exploration of factors associated with infant zinc status is warranted. Funding Sources: Bill and Melinda Gates Foundation.

Trace elements such as selenium and zinc are vital components of many enzymes, including endogenous antioxidants, and can interact with each other. Women with pre-eclampsia, the hypertensive disease of pregnancy, have been reported as having changes in some individual antioxidant trace elements during pregnancy, which are related to maternal and fetal mortality and morbidity. We hypothesised that examination of the three compartments of (a) maternal plasma and urine, (b) placental tissue and (c) fetal plasma in normotensive and hypertensive pregnant women would allow identification of biologically significant changes and interactions in selenium, zinc, manganese and copper. Furthermore, these would be related to changes in the angiogenic markers, placental growth factor (PlGF) and Soluble Fms-Like Tyrosine Kinase-1 (sFlt-1) concentrations. Venous plasma and urine were collected from healthy non-pregnant women (n = 30), normotensive pregnant controls (n = 60) and women with pre-eclampsia (n = 50) in the third trimester. Where possible, matched placental tissue samples and umbilical venous (fetal) plasma were also collected. Antioxidant micronutrient concentrations were measured by inductively coupled plasma mass-spectrometry. Urinary levels were normalised to creatinine concentration. Plasma active PlGF and sFlt-1 concentrations were measured by ELISA. Maternal plasma selenium, zinc and manganese were all lower in women with pre-eclampsia (p < 0.05), as were fetal plasma selenium and manganese (p < 0.05 for all); maternal urinary concentrations were lower for selenium and zinc (p < 0.05). Conversely, maternal and fetal plasma and urinary copper concentrations were higher in women with pre-eclampsia (p < 0.05). Differences in placental concentrations varied, with lower overall levels of selenium and zinc (p < 0.05) in women with pre-eclampsia. Maternal and fetal PlGF were lower and sFlt-1 higher in women with pre-eclampsia; maternal plasma zinc was positively correlated with maternal plasma sFlt-1 (p < 0.05). Because of perceptions that early- and late-onset pre-eclampsia have differing aetiologies, we subdivided maternal and fetal data accordingly. No major differences were observed, but fetal sample sizes were small following early-onset. Disruption in these antioxidant micronutrients may be responsible for some of the manifestations of pre-eclampsia, including contributing to an antiangiogenic state. The potential benefits of mineral supplementation, in women with deficient intakes, during pregnancy to reduce pre-eclampsia remain an important area for experimental and clinical research.

Plasma zinc and copper levels in maternal, placental intervillous space and cord blood

Effect of gestational age on cord blood plasma copper, zinc, magnesium and albumin.

Plasma concentrations of copper and zinc and leucocyte concentrations of zinc were measured in mothers during later pregnancy, at delivery, and 8-10 weeks after birth, and plasma concentrations of copper and zinc were measured in their infants at delivery and 8-10 weeks after birth. The 145 infants were either breast fed or fed one of two milk formulas supplying copper at different concentrations. None of the infants achieved the minimum copper intakes recommended by the World Health Organisation (WHO). At 2 months of age there were no major differences in growth or health detected in infants fed the different copper intakes. Infant birth weight correlated well with the ratio of maternal venous plasma zinc:maternal leucocyte zinc at delivery. Maternal venous plasma copper and zinc concentrations at birth correlated with umbilical venous plasma copper and zinc concentrations. Infants fed the higher copper content formulas had a low mean plasma zinc concentration without a significant increase in the mean plasma copper concentration. The present WHO recommendations regarding minimum copper intakes for infants fed formulas cannot be achieved with currently available formulas and are probably wrong.

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

Association between maternal serum zinc and birth weight is modified by neonatal SOD2 polymorphism and promoter methylation.