Pradeep Kumar M.1, Mayadevi Brahmanandan2, Dini S.B.3
BACKGROUND
Multiple micronutrient deficiencies commonly coexist in pregnancy and may play
a role in the pathogenesis of many high-risk events in pregnancy. Mineral
estimation during the first and second trimester may help in the identification of
high-risk pregnancies predisposed to pre-eclampsia, preterm birth or low birth
weight. Body mass index (BMI) is an independent risk factor influencing the serum
levels of micronutrients like iron, calcium, phosphorous and magnesium. The
purpose of this study was to compare the serum levels of iron, magnesium,
calcium and phosphorus during first & second trimesters of pregnancy and their
correlation with body mass index and adverse pregnancy outcomes.
METHODS
This was a longitudinal descriptive study, done over a period of twelve months,
from April 2017 to March 2018. 94 low risk pregnant women were selected in the
first trimester, and they were followed up for the entire duration of pregnancy. 2
ml of blood is collected at first and second trimester and analysed for the serum
levels of iron (μg/dl), magnesium (mg/dl), calcium (mg/dl) and inorganic
phosphorus (mg/dl). Mean values of these elements were noted and BMI was
measured. Patients were followed up to observe the pregnancy outcome,
especially development of hypertension, preterm birth and low birth weight. The
data were subjected to suitable statistical analyses. P value less than 0.05 is
considered as statistically significant.
RESULTS
Mean values of Ca, Mg, inorganic P and Fe were 9.3 mg/dl ± 0.52, 1.79 mg/dl ±
0.28, 3.59 mg/dl ± 0.54 and 83.7 μg/dl ± 25.36 respectively in first trimester and
8.9 mg/dl ± 0.47, 1.62 mg/dl ± 0.16, 3.17 mg/dl ± 0.44 and 76.17 μg/dl ± 21.
69 respectively in the second trimester. Hypocalcaemia was noted in 12.7 % and
38.3 % in the first and second trimester respectively. Hypomagnesaemia was seen
in 51.1 % and 80.9 % in the first and second trimester respectively.
Hypophosphatemia was seen in 3.2 % and 14.8 % in the first and second trimester
respectively. These findings were statistically significant. There was no significant
change in the iron levels in the present study. 19.1 % were underweight. 56.4 %
had normal BMI. 19.2 % were overweight. 5.3 % were obese.
CONCLUSIONS
There is no correlation between serum values of trace elements and the BMI of
study subjects. Even though significant hypocalcaemia, hypophosphatemia and
hypomagnesaemia was noted in second trimester compared to first, there was no
predisposition to the development of adverse outcomes like pre-eclampsia,
preterm birth or low birth weight. This may be the effect of dietary and
pharmacological supplementation during pregnancy.
