The Relationship between Cord Blood and Maternal Serum Zinc Levels and Birth Weight


1 Urmia University of Medical Sciences, Urmia, Iran

2 Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran


Background: Examining the relationship between cord blood and maternal serum zinc levels and birth weight.
Methods: A total of 127 infant-mother pairs were assigned to study (n = 58; with birth weight < 2500 g) and control (n = 69; with birth weight ≥ 2500 g) groups. Serum samples were collected from eligible mothers and cord blood of their low birth weight (LBW) or normal birth weight (NBW) healthy newborns. The inclusion criterion for the infant-mother pairs was lack of any medical complications. Serum zinc level was measured by using Inductively Coupled Plasma Mass Spectrometer method and the results were expressed in μg/dl. The two groups were compared in terms of maternal and cord blood serum zinc levels. Then, we evaluated their association with birth weight of neonates in both groups through Student’s t-test and one-way analysis of variance using SPSS.
Results: The study protocol was reviewed and approved by the ethics committee of the Urmia University of Medical Sciences (Ir.umsu.rec.1393.108 1393/04/24). Participants were provided with detailed information about the study and were assured that confidentiality would be maintained at all times. Written consent was obtained prior to data collection.
The mean age of the pregnant women was 26.1±5.8 years (age range: 18-40 years). The mean birth weight of the neonates in the two groups was 3275.9±552 kg. Pregnant women with serum zinc levels of higher than 70 μg/dl gave birth to neonates with birth weight higher than 3.5, whereas mothers with serum zinc levels of less than 60 μg/dl gave birth to infants with birth weight less than 3 kg (P=0.034). Mean serum zinc level in the cord blood of LBW group was 79.16±19.86 μg/dl, which was significantly lower than that in the NBW group (95.14±17.56 μg/dl; P<0.021). Similarly, mean maternal serum zinc level was 63.98±19.33 μg/dl in mothers who gave birth to LBW neonates, while it was 86.13±20.10 μg/dl in mothers with NBW neonates, indicating that serum zinc level was significantly lower in mothers with LBW infants than in those with NBW infants (P=0.017).
Conclusion: Maternal and cord blood zinc concentrations were shown to be associated with birth weight of the newborns


1. Lau C, Ambalavanan N, Chakraborty H, Wingate MS, Carlo WA. Extremely low birth weight and infant mortality rates in the United States. Pediatrics. 2013; 131(5):855-60.
2. MacDorman MF, Matthews TJ, Declercq E. Trends in out-of-hospital births in the United States, 1990- 2012. NCHS Data Brief. 2014; 144:1-8.
3. Etemad K, Yavari P, Mehrabi Y, Haghdoost A, Motlagh ME, Kabir MJ, et al. Inequality in utilization of in-patients health services in Iran. Int J Prev Med. 2015; 6:45.
 4. Moradi-Lakeh M, Vosoogh-Moghaddam A. Health sector evolution plan in Iran; equity and sustainability concerns. Int J Health Policy Manag. 2015; 4(10):637-40.
5. Moradi-Lakeh M, Namiranian N. Increasing trend of low birth weight in rural areas of iran: a warning. Iran J Pediatr. 2013; 23(1):123-4.
 6. Erenel H, Mathyk BA, Sal V, Ayhan I, Karatas S, Koc Bebek A. Clinical characteristics and pregnancy outcomes of Syrian refugees: a case–control study in a tertiary care hospital in Istanbul, Turkey. Arch Gynecol Obstet. 2017; 295(1):45-50.
7. Linsell L, Malouf R, Morris J, Kurinczuk JJ, Marlow N. Prognostic factors for cerebral palsy and motor impairment in children born very preterm or very low birthweight: a systematic review. Dev Med Child Neurol. 2016; 58(6):554-69.
8. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013; 382(9890):427-51.
9. Prasad AS. Discovery of human zinc deficiency: its impact on human health and disease. Adv Nutr. 2013; 4(2):176-90.
10. Bradshaw J. The wellbeing of children in the UK. Bristol: Policy Press; 2016.
 11. Moghaddam Tabrizi F, Saraswathi G. Maternal anthropometric measurements and other factors: relation with birth weight of neonates. Nutr Res Pract. 2012; 6(2):132-7.
12. Abass RM, Hamdan HZ, Elhassan EM, Hamdan SZ, Ali NI, Adam I. Zinc and copper levels in low birth weight deliveries in Medani Hospital, Sudan. BMC Res Notes. 2014; 7(1):386.
13. Gómez T, Bequer L, Mollineda A, González O, Diaz M, Fernández D. Serum zinc levels of cord blood: relation to birth weight and gestational period. J Trace Elem Med Biol. 2015; 30:180-3.
 14. Jyotsna S, Amit A, Kumar A. Study of serum zinc in low birth weight neonates and its relation with maternal zinc. J Clin Diagn Res. 2015; 9(1):SC01-3.
15. King JC. Determinants of maternal zinc status during pregnancy. Am J Clin Nutr. 2000; 71(5):1334S-43.
16. Srivastava S, Mehrotra PK, Srivastava SP, Siddiqui MK. Some essential elements in maternal and cord blood in relation to birth weight and gestational age of the baby. Biol Trace Elem Res. 2002; 86(2):97-105.
 17. Mori R, Ota E, Middleton P, Tobe-Gai R, Mahomed K, Bhutta ZA. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev. 2012; 7:CD000230.
 18. Shariati S, Yamini Y, Faraji M, Saleh A. On-line solid phase extraction coupled to ICP-OES for simultaneous preconcentration and determination of some transition elements. Microchim Acta. 2009; 165 (1-2):65-72.
 19. Jelliffe DB. The assessment of the nutritional status of the community. Geneva, Switzerland: World Health Organization; 1966. P. 271.
20. Prasad AS. Essential and toxic element: trace elements in human health and disease. New York: Elsevier; 2013.
21. Wilson RL, Grieger JA, Bianco-Miotto T, Roberts CT. Association between maternal zinc status, dietary zinc intake and pregnancy complications: a systematic review. Nutrients. 2016; 8(10):E641.
22. Gernand AD, Schulze KJ, Stewart CP, West KP Jr, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nat Rev Endocrinol. 2016; 12(5):274-89. 23. Crane JL, Cao X. Function of matrix IGF-1 in coupling bone resorption and formation. J Mol Med. 2014; 92(2):107-15.
 24. Petry N, Olofin I, Boy E, Donahue Angel M, Rohner F. The effect of low dose iron and zinc intake on child micronutrient status and development during the First 1000 days of life: a systematic review and meta-analysis. Nutrients. 2016; 8(12):E773.
25. Zahiri Sorouri Z, Sadeghi H, Pourmarzi D. The effect of zinc supplementation on pregnancy outcome: a randomized controlled trial. J Matern Fetal Neonatal Med. 2016; 29(13):2194-8.
26. Jyotsna S, Amit A, Kumar A. Study of serum zinc in low birth weight neonates and its relation with maternal zinc. J Clin Diagn Res. 2015; 9(1):SC01-3.
27. Riley C, Rubarth LB. Identifying maternal risk factors and influence on fetal risk. neonatal advanced practice nursing: a case-based learning approach. New York: Springer Publishing Company; 2016.
 28. Li Y, Liu QF, Zhang D, Shen Y, Ye K, Lai HL, et al. Weight gain in pregnancy, maternal age and gestational age in relation to fetal macrosomia. Clin Nutr Res. 2015; 4(2):104-9.
29. Li G, Kong L, Zhou H, Kang X, Fang Y, Li P. Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience. Sleep Med. 2016; 25:8-12.
 30. Ruiz-Núñez B, Pruimboom L, Dijck-Brouwer DJ, Muskiet FA. Lifestyle and nutritional imbalances associated with Western diseases: causes and consequences of chronic systemic low-grade inflammation in an evolutionary context. J Nutr Biochem. 2013; 24(7):1183-201.
 31. Ramakrishnan U, Young MF, Martorell R. Maternal nutrition and birth outcomes. Nutrition and health in a developing world. New York: Springer International Publishing; 2017. P. 487-502. 32. Λάγιου Π, Mucci L, Tamimi R, Kuper H, Λάγιου Α. Micronutrient intake during pregnancy in relation to birth size. Eur J Nutr. 2015; 44:52-9.