Biological Trace Element Research

, Volume 133, Issue 2, pp 162–170 | Cite as

The Role of Calcium, Magnesium, and Zinc in Pre-Eclampsia

  • Seema Jain
  • Priyamvada SharmaEmail author
  • Shobha Kulshreshtha
  • Govind Mohan
  • Saroj Singh


Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Its exact etiology is not known, although several evidences indicate that various elements might play an important role in pre-eclampsia. This study was carried out to analyze and to compare the concentration of calcium, magnesium, and zinc in the serum of women with pre-eclampsia and in normal pregnant women. Fifty clinically diagnosed patients with pre-eclampsia (25 with mild and 25 with severe pre-eclampsia) and 50 normal pregnant controls were enrolled in this study. The serum calcium, magnesium, and zinc levels were estimated with an atomic absorption spectrophotometer. The mean serum levels of calcium, magnesium, and zinc in normal pregnant group were 2.45 ± 0.18 mmol/L, 0.79 ± 0.13 mmol/L, and 15.64 ± 2.4 µmol/L, respectively, while in mild pre-eclamptic group, these were 2.12 ± 0.15 mmol/L, 0.67 ± 0.14 mmol/L, and 12.72 ± 1.7 µmol/L, respectively. Serum levels in severe pre-eclamptic group were 1.94 ± 0.09 mmol/L, 0.62 ± 0.11 mmol/L, and 12.04 ± 1.4 µmol/L, respectively. These results indicate that reduction in serum levels of calcium, magnesium, and zinc during pregnancy might be possible contributors in etiology of pre-eclampsia, and supplementation of these elements to diet may be of value to prevent pre-eclampsia.


Pre-eclampsia Calcium Magnesium Zinc 


  1. 1.
    Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD (2005) Hypertensive disorders in pregnancy. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD (eds) Williams obstetrics, 22nd edn. McGraw-Hill, New York, pp 761–808Google Scholar
  2. 2.
    Vasiljevic N, Vasiljevic M, Plecas D (1996) Role of nutritional factors in pre-eclampsia and eclampsia. Srp Arh Celok Lek 124:156–159PubMedGoogle Scholar
  3. 3.
    Motghare VM, Faruqui AA, Dudhgaonkar S, Purwar M (2003) Pharmacotherapy of hypertension in pregnancy: a review. Obstet Gynecol 8:541–549Google Scholar
  4. 4.
    Newman V, Fullerton TT (1990) Role of nutrition in the prevention of pre-eclampsia. J Nurse Midwifery 35:282–291CrossRefPubMedGoogle Scholar
  5. 5.
    Sibai BM (1998) Prevention of pre-eclampsia; a big disappointment. Am J Obstet Gynaecol 179:1275–1278CrossRefGoogle Scholar
  6. 6.
    Raman L, Shatrugna V (2002) Nutrition during pregnancy and lactation. In: Mahtab SB, Prahlad Rao N, Vinodini R (eds) Textbook of human nutrition. IBH, New Delhi, p 509Google Scholar
  7. 7.
    Pathak P, Kapil U (2004) Role of trace elements zinc, copper and magnesium during pregnancy and its outcome. Indian J Pediatr 71:1003–1005CrossRefPubMedGoogle Scholar
  8. 8.
    Wynn A, Wynn M (1988) Magnesium and other nutrients deficiencies as possible causes of hypertension and low birth weight. Nutr health 6:69–88PubMedGoogle Scholar
  9. 9.
    Deborah M (2000) Role of nutrition in prevention of toxemia. Am J Clin Nutr 72:S298–S300Google Scholar
  10. 10.
    Belizan JM, Villar J (1980) The relationship between calcium intake and edema, proteinuria and hypertension-gestosis: a hypothesis. Am J Clin Nutr 33:2202–2210PubMedGoogle Scholar
  11. 11.
    Hamlin RH (1952) The prevention of eclampsia and pre-eclampsia. Lancet 1:64–68CrossRefPubMedGoogle Scholar
  12. 12.
    Villar J, Belizan JM, Fischer PJ (1983) Epidemiologic observations on the relationship between calcium intake and eclampsia. Int J Gynaecol Obstet 21:271–278CrossRefPubMedGoogle Scholar
  13. 13.
    Belizan JM, Villar J, Repke J (1988) The relationship between calcium intake and pregnancy-induced hypertension: up-to-date evidence. Am J Obstet Gynecol 158:898–902PubMedGoogle Scholar
  14. 14.
    Kumru S, Aydin S, Simsek M, Sahin K, Yaman M, Ay G (2003) Comparison of serum copper, zinc, calcium, and magnesium levels in pre-eclamptic and healthy pregnant women. Biol Trace Elem Res 94:105–112CrossRefPubMedGoogle Scholar
  15. 15.
    Kazerooni T, Hamze-Nejadi S (2003) Calcium to creatinine ratio in a spot sample of urine for early prediction of pre-eclampsia. Int J Gynaecol Obstet 80:279–283CrossRefPubMedGoogle Scholar
  16. 16.
    Duvekot EJ, DeGroot CJ, Bloemenkamp KW, Oei SG (2002) Pregnant women with a low milk intake have an increased risk of developing pre-eclampsia. Eur J Obstet Gynecol Reprod Biol 105:11–14CrossRefPubMedGoogle Scholar
  17. 17.
    Sarma PC, Gambhir SS (1995) Therapeutic uses of magnesium. Indian J Pharmacol 27:7–13Google Scholar
  18. 18.
    Doyle W, Crawford MA, Wynn AH, Wynn SW (1989) Maternal magnesium intake and pregnancy outcome. Magnes Res 2:205–210PubMedGoogle Scholar
  19. 19.
    Touyz RM (2003) Role of magnesium in pathogenesis of hypertension. Mol Aspects Med 24:107–136CrossRefPubMedGoogle Scholar
  20. 20.
    King JC (2000) Determinants of maternal zinc status during pregnancy. Am J Clin Nutr 71:S1334–S1343Google Scholar
  21. 21.
    Muller O, Krawinkel M (2005) Malnutrition and health in developing countries. CMAJ 173:279–286PubMedGoogle Scholar
  22. 22.
    Gibson RS (1994) Zinc nutrition in developing countries. Nutr Res Rev 7:151–173CrossRefPubMedGoogle Scholar
  23. 23.
    Black RE (2001) Micronutrients in pregnancy. Br J Nutr 85:S193–S197CrossRefPubMedGoogle Scholar
  24. 24.
    Christian P (2003) Micronutrients and reproductive health issues: an international perspective. J Nutr 133:S1969–S1973Google Scholar
  25. 25.
    Picciano MF (2003) Pregnancy and lactation: physiological adjustments, nutritional requirements and the role of dietary supplements. J Nutr 133:S1997–S2002Google Scholar
  26. 26.
    LA YasodharaP R, Raman L (1991) Trace minerals in pregnancy.1.Copper and zinc. Nutr Res 11:15–21CrossRefGoogle Scholar
  27. 27.
    Mahomed K, Williams MA, Woelk GB, Mudzamiri S, Madzime S, King IB, Bankson DD (2000) Leukocyte selenium, zinc, and copper concentrations in pre-eclamptic and normotensive pregnant women. Biol Trace Elem Res 75:107–118CrossRefPubMedGoogle Scholar
  28. 28.
    Prasad AS (1985) Clinical manifestations of zinc deficiency. Ann Rev Nutr 5:341–363CrossRefGoogle Scholar
  29. 29.
    Jameson S (1993) Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Ann N Y Acad Sci 678:178–192CrossRefPubMedGoogle Scholar
  30. 30.
    Chien PF, Khan KS, Arnott N (1996) Magnesium sulphate in the treatment of eclampsia and pre-eclampsia: an overview of the evidence from randomised trials. Br J Obstet Gynaecol 103:1085–1091PubMedGoogle Scholar
  31. 31.
    Friedman PA (2006) Agents affecting mineral ion homeostasis and bone turnover. In: Brunton LL, Lazo JS, Parker KL (eds) Goodman and Gillman’s. The pharmacological basis of therapeutics, 11th edn. Mc Graw-Hill, New YorkGoogle Scholar
  32. 32.
    Osendrep SJM, West SE, Black RE (2003) The need for maternal zinc supplementation in developing countries. J Nutr 133:S817–S827Google Scholar
  33. 33.
    Adam B, Malatyalioglu E, Alvur M, Talu C (2001) Magnesium, zinc and iron levels in pre-eclampsia. J Matern Fetal Med 10:246–250PubMedGoogle Scholar
  34. 34.
    Joshi VK, Sapre S, Govilla V (2003) Role of micronutrients and calcium in pregnancy induced hypertension. Obs Gynae Today 8:617–619Google Scholar
  35. 35.
    Sukonpan K, Phupong V (2005) Serum calcium and serum magnesium in normal and pre-eclamptic pregnancy. Arch Gynecol Obstet 273:12–16CrossRefPubMedGoogle Scholar
  36. 36.
    Standley CA, Whitty JE, Mason BA, Cotton DB (1997) Serum ionized magnesium levels in normal and preeclamptic gestation. Obstet Gynecol 89:24–27CrossRefPubMedGoogle Scholar
  37. 37.
    Golmohammed S, Amirabi lou A, Yazdian M, Pashapour N (2008) Evaluation of serum calcium, magnesium, copper, and zinc levels in women with pre-eclampsia. Iran J Med Sci 33:231–234Google Scholar
  38. 38.
    Levine RJ, Hauth JC, Curet LB, Sibai BM, Catalano PM, Morris CD, Dersimonian R, Esterlitz JR, Raymond EG, Bild DE, Clemens JD, Cutler JA (1997) Trial of calcium to prevent preeclampsia. N Eng J Med 337:69–76CrossRefGoogle Scholar
  39. 39.
    Kisters K, Korner J, Lowen F, Witteler R, Jackisch C, Zidek W, Ott S, Westermann G, Barenbrock M, Rahn KH (1998) Plasma and membrane calcium ion and magnesium concentrations in normal pregnancy and pre-eclampsia. Gynaecol Obstet Invest 46:158–163CrossRefGoogle Scholar
  40. 40.
    Kosch M, Hausberg M, Louwen F, Barenbrock M, Rahn KH, Kisters K (2000) Alterations of plasma calcium and intracellular and membrane calcium in erythrocytes of patients with pre-eclampsia. J Hum Hypertens 14:333–336CrossRefPubMedGoogle Scholar
  41. 41.
    Malas NO, Shurideh ZM (2001) Does serum calcium in pre-eclampsia and normal pregnancy differ? Saudi Med J 22:868–871PubMedGoogle Scholar
  42. 42.
    Steinert JR, Wyatt AW, Poston L, Jacob R, Mann GE (2002) Preeclampsia is associated with altered Ca2+ regulation and NO production in human fetal venous endothelial cells. FASEB 16:721–738Google Scholar
  43. 43.
    Sanders GT, Huijgen HJ, Sanders R (1999) Magnesium in disease: a review with special emphasis on the serum ionized magnesium. Clin Chem Lab Med 37:1011–1033CrossRefPubMedGoogle Scholar
  44. 44.
    Villanueva LA, Figueroa A, Villanueva S (2001) Blood concentrations of calcium and magnesium in women with severe pre-eclampsia. Ginecol Obstet Mex 69:277–281PubMedGoogle Scholar
  45. 45.
    Prema K (1980) Predictive value of serum copper and zinc in normal and abnormal pregnancy. Indian J Med Res 71:554–560PubMedGoogle Scholar
  46. 46.
    Borella P, Szilagyi A, Than G, Csaba I, Giardino A, Faccinetti F (1990) Maternal plasma concentrations of magnesium, calcium, zinc and copper in normal and pathological pregnancies. Sci Total Environ 99:67–76CrossRefPubMedGoogle Scholar
  47. 47.
    Ajayi G (1993) Concentrations of calcium, magnesium, copper, zinc and iron during normal and EPH-gestosis pregnancy. Trace Element Med 10:151–152Google Scholar
  48. 48.
    Ette A, Ibeziako PA (1985) Plasma zinc and copper concentrations in pregnant Nigerian women and newborn. Afr J Med Sci 14:99–103Google Scholar
  49. 49.
    Ilhan N, Simsek M (2002) The changes of trace element, malondialdehyde levels and super oxide dismutase activities in pregnancy with or without pre-eclampsia. Clin Biochem 35:393–397CrossRefPubMedGoogle Scholar
  50. 50.
    Power ML, Heaney RP, Kalkwarf HJ, Pitkin RM, Repke JT, Tsang RC, Schulkin J (1999) The role of calcium in health and disease. Am J Obstet Gynecol 181:1560–1569CrossRefPubMedGoogle Scholar
  51. 51.
    Skjaerven R, Wilcox A, Lie RT (2002) The interval between pregnancies and the risk of pre-eclampsia. N Engl J Med 346:33–38CrossRefPubMedGoogle Scholar
  52. 52.
    Altura BM, Altura BT (1984) Magnesium, electrolyte transport and coronary vascular tone. Drug 28(S):120–142CrossRefGoogle Scholar
  53. 53.
    Kumar CA, Das UN (2000) Lipid peroxides anti-oxidants and nitric oxide in patients with pre-eclampsia and essential hypertension. Med Sci Monit 6:901–907PubMedGoogle Scholar
  54. 54.
    Roberts JM, Redman CWG (1993) Pre-eclampsia: more than pregnancy induced hypertension. Lancet 341:1447–1451CrossRefPubMedGoogle Scholar
  55. 55.
    Thakur S, Gupta N, Kakkar P (2004) Serum copper and zinc concentrations and their relation to superoxide dismutase in severe malnutrition. Eur J Pediatr 163:742–744CrossRefPubMedGoogle Scholar

Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • Seema Jain
    • 1
  • Priyamvada Sharma
    • 1
    Email author
  • Shobha Kulshreshtha
    • 1
  • Govind Mohan
    • 1
  • Saroj Singh
    • 1
  1. 1.S.N. Medical CollegeAgraIndia

Personalised recommendations