Insights into the Micronutrient and Cardiovascular Health Risks during Pregnancy.

BACKGROUND

Calcium (Ca), iron (Fe), and copper (Cu) during pregnancy may have both cardiovascular protective and risk effects, but their dose-response relationship is still unclear.

OBJECTIVES

This study aims to explore the effects of serum essential metals Cu, Fe, and Ca during pregnancy on cardiovascular health risks (CVRs) and the biomarkers of endothelial cell activation [cell adhesion molecules (CAMs): intercellular adhesion molecule-1 (ICAM-1) and E-selectin].

METHODS

We analyzed 2430 pregnant women from the Maternal and Infant Health cohort study in Hefei II. CVR-increased at 24-28 gestational weeks was defined using 5 clinical cardiovascular disease risk indicators. CAMs were measured in maternal blood at 24-28 wk in all participants. In addition, a random subset of 500 mother-infant pairs was selected for follow-up CAMs assessment, including 454 women with valid third-trimester maternal blood samples and 447 women with valid cord blood samples at delivery.

RESULTS

Using these 5 clinical cardiovascular disease risk indicators, 54.3% of the pregnant women were classified into the CVR-increased group. Compared with the lowest Fe status (first quartile, Q1), pregnant women in second quartile (Q2) and third quartile (Q3) had lower odds of CVR-increased [odds ratio (OR) = 0.79 and 0.77, respectively], whereas the association was not significant in fourth quartile (Q4). In contrast, higher Cu was associated with a greater odds of CVR-increased (OR 1.39 for Q4 compared with Q1). In CAMs analyses, we found a U-shaped relationship between serum Fe concentration and ICAM-1, and the positive association between Fe and ICAM-1 and E-selectin was mainly reflected when the serum Fe concentration was high. No significant association was observed for CAMs measured in maternal blood in late pregnancy and umbilical cord blood at delivery.

CONCLUSIONS

For the cardiovascular health of pregnant women, maintaining appropriate serum micronutrient levels, avoiding deficiency and excess, may be more important than simply supplementing. This study provides new insights into the relationship between serum micronutrients and CVR in pregnant women.