Essential trace elements status in portuguese pregnant women and their association with maternal and neonatal outcomes: A prospective study from the IoMum Cohort

Cobalt (Co), copper (Cu), manganese (Mn), molybdenum (Mo), and zinc (Zn) are essential trace elements (ETEs) important in cellular chemical reactions and antioxidant defense. Ingestion of ETEs during pregnancy is crucial but their role in specific pregnancy outcomes is largely unknown. This study aimed to quantify urinary levels of these ETEs in pregnancy and to evaluate their role in pregnancy health. First trimester pregnant women of Porto and Lisbon regions provided a urine sample, and sociodemographic and lifestyle data. Clinical data were obtained from clinical records. Urinary ETEs were quantified by inductively coupled plasma mass spectrometry (ICP-MS). Our results show that having urinary Zn levels above the 50th percentile (P50) increases the risk of pre-eclampsia (PE). On the other hand, urinary Zn levels above the P50 decreased the risk of being born with head circumference small for gestational age but it increased the risk having length small for gestational age at birth. This study may provide valuable information for public health policies related to prenatal nutrition, while informing future efforts to de-fine urinary reference intervals for ETEs in pregnant women