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DOI: 10.1002/jcla.22398
RESEARCH ARTICLE
1
Gynecology and Obstetrics Clinic,
Yenimahalle Training and Research Hospital, Backround: The relationship between maternal zinc level and birth weight, birth week,
Yildirim Beyazıt University, Ankara, Turkey delivery type, garvida, maternal age, etc., contribute to diagnosis and clinical
2
Department of Biochemistry, Ankara follow-up.
University Faculty of Medicine, Ankara, Turkey
3 Method: Multivariate investigated for data of 275 patients were obtained during their
Department of Biochemistry, Yenimahalle
Training and Research Hospital, Yildirim pregnancy periods until birth. 3 cc blood samples were centrifuged for 15 minutes at
Beyazıt University, Ankara, Turkey
2500 g within a period of 30 minutes and were stored at −80°C until the time of
Correspondence analysis. The zinc levels of the patients were found to be within the range of 49-
Özgül Özgan Çelikel, Gynecology and
129 μg/dL. Patients were divided into 8 groups according to their zinc levels (49-59,
Obstetrics Clinic, Yenimahalle Training and
Research Hospital, Yildirim Beyazıt University, 60-69, …, 120-129) and the relationships of zinc level with the parameters related to
Ankara, Turkey.
the mode of delivery, week of delivery, birth weight, age, early membrane rupture,
Email: drozgulozgan@gmail.com
live-stillbirth, and gravid were statistically analyzed to determine differences between
the groups.
Results: There was a significant difference between the live births and stillbirths with
a 95% confidence level regarding the zinc level. The zinc level affected the live-
stillbirth status; patients with a zinc level of 49-59 μg/dL had stillbirths, the live birth
rate for 59-69 μg/dL was approximately 50%, whereas it was approximately 88% for
in the patients with a zinc level of 109-119 μg/dL. All patients with a zinc level of
119 μg/dL and above had live births.
Conclusion: Based on the results of this study, it is suggested that zinc supplementa-
tion may be an appropriate treatment for the pregnant women with low zinc levels to
provide the realization of live births.
KEYWORDS
early membrane rupture, pregnancy, small for gestational age, zinc
J Clin Lab Anal. 2018;e22398. wileyonlinelibrary.com/journal/jcla © 2018 Wiley Periodicals, Inc. | 1 of 5
https://doi.org/10.1002/jcla.22398
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T A B L E 1 Descriptive statistics for live-stillbirth status according found to be in a range from 49 to 129 μg/dL.Serums were diluted to
to zinc levels 1/5 and worked. The normal range of zinc was 70-115 μg/dL. The
Parameters Live-stillbirth results test range was 15-250 μg/dL. The lower limit of detectable zinc level
was 10 μg/dL The investigated parameter of zinc level was evaluated
Zinc range Live birth Stillbirth No delivery Sig.
in 8 groups in 10-unit increments as follows: 49-59, 60-69, 70-79,
49 ≤ x < 59 6 1 6 0.42 80-89, 90-99, 100-109, 110-119, and 120-129 μg/dL. Delivery meth-
59 ≤ x < 69 22 4 6 0.49 ods were categorized as abortion, normal birth, and cesarean section,
69 ≤ x < 79 39 1 11 0.378 history of the previous cesarean section, ectopic pregnancy, and in-
79 ≤ x < 89 49 4 10 0.481 tentional termination of pregnancy. Delivery weeks were categorized
Have a cesarean
Zinc range Abortion Vaginal delivery Section before Ectopic Terminated Total Sig.
49 ≤ x < 59 4 3 3 1 0 2 13 0.900
59 ≤ x < 69 3 17 3 5 1 3 32 0.686
69 ≤ x < 79 9 25 7 7 0 3 51 0.600
79 ≤ x < 89 9 31 10 12 0 1 63 0.695
89 ≤ x < 99 7 26 9 8 1 2 53 0.671
99 ≤ x < 109 2 19 9 10 1 1 42 0.762
109 ≤ x < 119 1 6 4 6 0 0 17 0.579
119 ≤ x < 129 0 2 2 0 0 0 4
Total 35 129 47 49 3 12 275
4 | DISCUSSION
3.2 | The effect of the zinc level on delivery method
Data analysis was performed for 8 sub-groups of zinc level in the Most of the studies on zinc use during pregnancy were not well-
range of 49-129 μg/dL and for 6 sub-groups of delivery methods, and designed, and the study groups were small; therefore, their results were
results were presented in tables (Table 2). not very clear, and they could merely provide recommendations.12
Previous studies conducted on the effects of zinc level on preg-
nant women have emphasized the importance of the zinc level, and
3.3 | The effects of zinc level on the gestational
zinc supplementation has been suggested in patients when required.
week of delivery
In the study, of a total of 275 pregnant women, 215 of them had a
With the aim of investigating the relationship between zinc level and the live birth, 12 of them had a stillbirth, and 48 of them did not have
gestational week of delivery, the descriptive analysis of gestational week birth. Regarding the delivery method, 35 of them had an abortion,
of delivery according to zinc level was presented below (Table 3). 129 of them had a normal birth, 47 of them had a cesarean section,
49 of them had a history of the previous cesarean section, 3 of them
were diagnosed with ectopic pregnancy, and 12 had their pregnan-
3.4 | The effect of zinc level on birth weight
cies intentionally terminated. Zinc deficiency rate was 4.6% in the first
With the aim of investigating the relationship between zinc level and trimester of pregnancy.
birth weight, the descriptive analysis of birth weight according to the In this study; 9 (75%) of 12 stillbirth patients were in the 24-
zinc level was presented below (Table 4). 37th week of pregnancy, whereas 3 (25%) of them were past the
41st week of their pregnancy; however, no stillbirths were found in
term pregnancies. 10 (83.3%) of the stillbirth patients were found to
3.5 | The effect of zinc level on EMR
have a birth weight of 2500 g or less, and EMR was found in only 2
With the aim of investigating the relationship between zinc level and of the patients.
EMR, the descriptive analysis of EMR with respect to zinc level was In a study conducted in the year 2000, it was reported that mater-
presented below (Table 5). nal age, gestational weight, parity, and gravida had minor roles in the
zinc level in pregnancy.13
In our study, we also did not find any significant relationship be-
3.6 | The effect of zinc level on gravid
tween birth weight and zinc level. In 2 studies conducted on 415 preg-
With the aim of investigating the relationship between zinc level and nant women in Gaziantep, one of the cities in our country, no changes
gravid, the descriptive analyzes of gravid with respect to zinc level in zinc levels were found during pregnancy.14
were presented below (Table 6). In our study, no baby with an anomaly was identified.
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Between 37
Zinc range Abortion 24-37 wk and 41 wk 41 wk and over Ectopic Terminated Total Sig.
49 ≤ x < 59 4 3 1 3 0 2 13 0.786
59 ≤ x < 69 3 7 15 3 1 3 32 0.945
69 ≤ x < 79 9 9 26 4 0 3 51 0.819
79 ≤ x < 89 9 12 30 11 0 1 63 0.979
89 ≤ x < 99 7 13 23 7 1 2 53 0.667
99 ≤ x < 109 3 10 20 7 1 1 42 0.525
109 ≤ x < 119 2 5 9 1 0 0 17 0.302
119 ≤ x < 129 0 1 3 0 0 0 4
Total 37 60 127 36 3 12 275
Zinc range Abortion 2500 g and below 2500-4000 g 4000 g and over Ectopic Terminated Total Sig.
49 ≤ x < 59 4 2 5 0 0 2 13 0.985
59 ≤ x < 69 3 5 19 1 1 3 32 0.637
69 ≤ x < 79 9 5 30 4 0 3 51 0.581
79 ≤ x < 89 9 7 42 4 0 1 63 0.847
89 ≤ x < 99 7 4 34 5 1 2 53 0.469
99 ≤ x < 109 2 1 33 4 1 1 42 0.374
109 ≤ x < 119 1 3 11 2 0 0 17 0.645
119 ≤ x < 129 0 1 3 0 0 0 4
Total 35 28 177 20 3 12 275
T A B L E 5 The Descriptive statistics for EMR according to zinc T A B L E 6 Descriptive statistics for gravid with respect to zinc
level level
Zinc range (+) (−) Total Sig. Zinc range 1 2 and 3 4 and over Total Sig.
60% in the patients with a zinc level between 79-89 μg/dL and 89-
When the effect of the zinc level on live-stillbirth status was eval- 99 μg/dL, 81% in the patients with a zinc level of 99-109 μg/dL, and
uated, it was found that patients with a zinc level of 49-59 μg/dL had 88% in the patients with a zinc level of 109-119 μg/dL, approximately.
stillbirths. The live birth rate was 50% in the patients with a zinc level All of the patients with a zinc level of 119 μg/dL and above had live
of 59-69 μg/dL, 55% in the patients with a zinc level of 69-79 μg/dL, births.
ÖZGAN ÇELIKEL et al. |
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