Maternal Serum Zinc Levels During Pregnancy And Fetal Congenital Heart Disease And The Value Of Combined Phosphatase Activity

Objective:Congenital heart disease(CHD)is a congenital malformation of the heart and blood vessels with certain pathogenesis during embryonic development.Clinical studies have preliminarily shown that maternal serum zinc deficiency during pregnancy is associated with fetal CHD.Serum zinc is a direct indicator of zinc level.As the zinc level fluctuates and changes,minor instantaneous detective values can hardly reflect real zinc metabolic status accurately.Serum alkaline phosphatase activity may reflect zinc nutritional status in the body,and it may be more accurately to reflect zinc status by combining the both parameters,which should,however,be confirmed by more supportive data.This clinical study investigated the relationship between maternal serum zinc deficiency and fetal CHD and the auxiliary application of alkaline phosphatase activity.We compared the serum zinc concentration and alkaline phosphatase activity of the pregnant women between those whose fetuses were diagnosed with CHD and the ones with normal fetuses.The present work may provide useful references for scientific and adequate nutrition supplement during pregnancy and prevention strategy of CHD,so as to reduce the occurrence of CHD.Methods:We conducted a hospital-based case-control study with a 1:1 paired design.The pregnant women who underwent prenatal examination at Fujian Maternity and Child Health Hospital from February 2020 to February 2021 were participated as the research subjects.The case group(or CHD group)consisted of 36 pregnant women,whose fetuses had been diagnosed with CHD.They were further divided into complex CHD subgroup(n = 20)and simple CHD subgroup(n = 16).The control group comprised of36 counterparts,who experienced a normal pregnancy with the absence of any abnormality in their fetuses.Gestational age was matched between the two groups.Women from the case group were treated with extraction of venous blood before inducing labor or delivery,and venous blood was extracted accordingly for the control group during prenatal examination.We reviewed the prenatal examination records of the subjects in the early trimester of pregnancy for the alkaline phosphatase activity and other related measurements.Maternal serum zinc concentration and alkaline phosphatase activity were compared between the CHD and control groups,and between the complex and simple CHD groups.Results:1.Maternal serum zinc levels were significantly lower in the CHD group than those in the normal group in the middle and late trimesters(P<0.05).2.Maternal alkaline phosphatase activity was also significantly lower in the CHD group compared with the control group in the early and middle trimesters(P<0.05).There was no significant difference when the comparison was made between the CHD and control groups in the late trimester(P>0.05),although the activity appeared to be lower in the CHD group.3.Although the level of serum zinc was lower in the complex CHD subgroup than in the simple CHD subgroup with no statistically significant difference(P>0.05),the alkaline phosphatase activity was significantly lower in the complex CHD subgroup than that in the simple CHD subgroup(P<0.05).Conclusions:1.Maternal serum zinc deficiency during pregnancy is associated with fetal CHD.2.Serum alkaline phosphatase activity is an eligible auxiliary indicator for zinc metabolism in the body.