Comparison of maternal serum micronutrients with dual test scores in pregnant women with adverse pregnancy outcomes

Background: The dual test is the most used aneuploidy screening method in first-trimester pregnancy. Abnormally high or low values of PAPP-A and β hCG are associated with adverse pregnancy outcomes. Increased free β -hCG were associated with pregnancy complications including late fetal loss, gestational hypertension, pre-eclampsia, FGR (Fetal growth restriction), preterm delivery and dead fetus in utero. Score developed in dual test does not consider maternal trace elements in the prediction of APO. Presently there are no studies correlating serum trace elements with PAPP-A, beta HCG CRL, NT and aneuploidy risk among pregnancies that had APO. So, we aimed to associate serum micronutrients, PAPP-A and aneuploidy risk score calculated by dual test in pregnant women (20-40 yrs) upto 13^th week of pregnancy (i.e first trimester) with different APO. Aims and Objective: The study aims to associate serum copper, zinc, magnesium, iron, Pregnancy-Associated Plasma Protein A and aneuploidy risk score calculated by taking dual test in pregnant ladies (20-40yrs) up to 13^th week of pregnancy with different adverse pregnancy outcomes Materials and Methods: This cohort study was conducted in Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka, India, from March2019 to March2022.Ethical approval was obtained from the Institutional Ethical Committee (IEC No 182/2019). The study has been registered under “The Clinical Trials Registry India,” -REF/2020/01/030393. The pregnancy was followed up for any adverse pregnancy outcomes. Results: we found n=102 mothers had normal delivery, n=46 had FGR, n=57 had gestational diabetes mellitus and n=68 had preterm delivery. In FGR group, serum zinc showed positive relation with PAPPA (r=0.7, p<0.001) and Multiple of Median (MoM) of PAPPA (r=0.77, p<0.001). Conclusion: In FGR group, maternal serum zinc had a significant positive correlation with PAPP-A showing that there is association between the two. We conclude that the possible role of micronutrients and zinc deficiency needs to be investigated in depth.