Zinc is one of the elements necessary for growth and health in human. Some evidences indicate that the zinc deficiency is one of real difficulties for the public health in developed and developing countries. Since the pregnant women are more at risk by the zinc deficiency, and this can cause many problems, in this study we tried to find out the rate of zinc deficiency in pregnant women within the region. This research project was analytical-descriptive study which was done on the 400 pregnant women whom referred to Zahedan Ghods hospital. A questionnaire was set up for each case which contained the following items, mother age, pregnancy age, numbers of deliveries, education, and consumption of iron tablet during pregnancy. The serum zinc level in each mother in this project was determined by atomic absorption technique. Prevalence of zinc deficiency among the pregnant women was 49%. Statistical analysis indicated that zinc deficiency had correlation with mother age, term of pregnancy and iron consumption. But zinc deficiency showed no correlation with numbers of deliveries and education. © Iranian Journal of Public Health. All rights reserved

Joshaghani, H.R.

Mansourian, A.R.

Salimi, S.

Yaghmaei, M.

Iranian Journal of Public Health

English

Zinc is one of the elements necessary for growth and health in human. Some evidences indicate that the zinc deficiency is one of real difficulties for the public health in developed and developing countries. Since the pregnant women are more at risk by the zinc deficiency, and this can cause many problems, in this study we tried to find out the rate of zinc deficiency in pregnant women within the region. This research project was analytical-descriptive study which was done on the 400 pregnant women whom referred to Zahedan Ghods hospital. A questionnaire was set up for each case which contained the following items, mother age, pregnancy age, numbers of deliveries, education, and consumption of iron tablet during pregnancy. The serum zinc level in each mother in this project was determined by atomic absorption technique. Prevalence of zinc deficiency among the pregnant women was 49%. Statistical analysis indicated that zinc deficiency had correlation with mother age, term of pregnancy and iron consumption. But zinc deficiency showed no correlation with numbers of deliveries and education

S Salimi

M Yaghmaei

HR Joshaghani

AR Mansourian

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Study of Zinc Deficiency in Pregnant Women

Golestan University of Medical Sciences Repository

Iranian J Publ Health, 200 Iranian J Publ Health, 2004, Vol. 33, No. 3, pp.15-18 4, Vol. 33, No. 3, pp.15-18                                                 Study of Zinc Deficiency in Pregnant Women S Salimi 1, M Yaghmaei 2,* HR Joshaghani 3, AR Mansourian 4  1Dept. of Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Iran 2Dept. of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Iran 3Dept. of Medical Laboratory, School of Allied Medicine, Golestan University of Medical Sciences, Iran 4 Dept. of Biochemistry, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran Abstract Zinc is one of the elements necessary for growth and health in human. Some evidences indicate that the zinc deficiency isone of real difficulties for the public health in developed and developing countries.  Since the pregnant women are more at risk by the zinc deficiency, and this can cause many problems, in this study we tried to find out the rate of zinc deficiency in pregnant women within the region. This research project was analytical-descriptive study which was done on the 400pregnant women whom referred to Zahedan Ghods hospital. A questionnaire was set up for each case which contained thefollowing items, mother age, pregnancy age, numbers of deliveries, education, and consumption of iron tablet during pregnancy. The serum zinc level in each mother in this project was determined by atomic absorption technique. Prevalence of zinc deficiency among the pregnant women was 49%. Statistical analysis indicated that zinc deficiency had correlationwith mother age, term of pregnancy and iron consumption. But zinc deficiency showed no correlation with numbers of deliveries and education.Keywords: Zinc deficiency, Mother Age, Pregnancy age, Iran Introduction Zinc is one of the trace elements necessary for health and growth. It is present in the biologi­cal fluid as Zn++. This caption has many bio­logical functions, which is related to its main function as a co-factor in more than 300 en­zymes. Zn++ also participates in the distributionof proteins and gene expression. It also stabi­lizes the structure of protein and nucleic acids. Zinc also preserves the intracellular organellessituation, plays a role in the transfusion, and immunological responses (1). Evidences suggest that zinc deficiency is one of the important problems within the developed and developing countries (2). In 1991, a report was published which emphasized the impor­tance of zinc and also indicated that in countries such as Iran, Egypt, Turkey, China, Yugoslavia, and Canada, due to low consumption of red meat, and high consumption of fiber, zinc defi­ciency was seen quiet often (2). Zinc deficiencyin human was reported for the first time in Iranin 1961(3) and in Egypt in 1963 (4). Pregnant women are facing zinc deficiencymore than the other groups, due to having fetus which need zinc for its proper growth (5). Higher age, lactation, alcoholism, and high consumption of iron, and folic acid, increase the risk of zinc deficiency (1, 6). Other re­searches have shown that the fetus grown by zinc deficiency is end up with abnormalities in central nervous systems (6, 7). In an other study done on the zinc deficient pregnant women, itwas indicated that congenital abnormalities,prolonged pregnancy, abnormal tasting sense, and other difficulties were seen in such subjects(7). A separate study in 2001 indicated that us­ing supplementary zinc materials by pregnant *Corresponding author: Tel: +98 21 8058742, Fax: +98 21 8058719, E-mail: sasalimi@yahoo.com 15                                                                                         S Salimi et al: Study of Zinc… mother, increased newborn birth weight, anddecreased the mortality rate (8). According to high zinc deficiency prevalence inthe girls of Zahedan and effect of zinc defi­ciency on fetus, we evaluated the prevalence of zinc deficiency in pregnant women in that area.  Materials and Methods This research was an analytical- descriptive study, which was conducted on 400 pregnant women whom referred to Zahedan Ghods hos­pital in 2001. According to a previous research, 400 cases were chosen (9).  Those that their pregnancy led to twin or more were omitted from this investigation. The gyne­cologist briefed the pregnant women in this re­search, and their verification was taken for the research. For each mother a questionnaire wasprovided which contained the following items: mother age, third trimester, numbers of deliv­eries, level of education, and iron consumption (yes or no). We divided mothers according to age to three groups, group 1 (<20 years), group 2 (20-30 years) and group 3 (>30 years), and also ac­cording to fetus age to three groups, group 1 (first trimester of pregnancy), group 2 (second trimester of pregnancy) and group 3 (third tri­mester of pregnancy).We also divided mothers according to number of deliveries to three groups, group 1 (1-2 deliveries), group 2 (3-4 deliveries) and group 3 (>4 deliveries), and ac­cording to use of iron tablet to two groups. Two ml blood was taken from each pregnant woman. The serum zinc was determined by atomic absorption instrument (PU9100X-Phil­ips). Those pregnant women having zinc con­centration less than 70 µg/dl marked as zinc deficient (1).Results The serum zinc level in 204 individuals (51%) was on the normal range and in 196 samples(49%) were less than normal. Table 1 shows the results of zinc deficiency according to the mother age. Prevalence of zinc deficiency inthree groups, <20 years, 20-30 years and >30 years in this study showed a meaningful corre­lation (P= 0.02, DF = 1, X2 5.2). Zinc deficiency was also analyzed according to the fetus age (Table 2). The prevalence of zinc deficiency in this study also showed a meaning­ful correlation (P = 0.007, DF = 2, X2 = 9.84).The results from X2 study of zinc deficiency between group 1 and group 2 did not show meaningful difference. But between group 2 and group 3 there was a meaningful difference (P= 0.02, DF= 1, X2= 5.2). There was a similar finding between group 1 and group 3 which showed meaningful differences. The prevalent of zinc deficiency among three groups of the pregnant women according to the number of deliveries did not show a meaningful difference (P= 0.08, DF= 2, X2= 5.5). But therewas a meaningful difference between groups 1 and 3 (P = 0.019, DF = 1, X2 = 5.5). The prevalence of zinc deficiency among thepregnant women was also studied according to the level of education. Results from this inves­tigation indicated that there was not any mean­ingful difference in this regard at all. Table 3shows the results of zinc deficiency among thepregnant women according to use of iron tablet or not. The prevalence of zinc deficiency among the women showed a meaningful differ­ence (P= 0.001, DF= 1, X2= 9.6). Table 1: Frequency distribution of serum zinc level inpregnant women according to mother age Mother’s age zinc<70 µg/dl zinc>70 µg/dl No (Year) (n) (%) (n) (%) < 20 40 44 52 56 92 20-30 96 59 67 41 163 > 30 62 43 83 58 145 Total 400 P=0.02, DF=2, X2=7.816                                                                                                                                      Iranian J Publ Health, 2004, Vol. 33, No. 3, pp.15-18  Table 2: Frequency distribution of serum zinc levelaccording to fetus age (trimester of pregnancy) Term of zinc<70 µg/dl zinc>70 µg/dl No pregnancy(n) (%) (n) (%)First 78 61 50 39 128 Trimester Second 69 57 54 44 123 Trimester Third 61 41 88 59 149 Trimester Total 400 P=0.007, DF=2, X2=9.84 Table 3: Frequency distribution of frequency of serumzinc level in pregnant women according to Iron con­sumption Iron zinc<70µg/dl zinc>70µg/dl No consumption(n)  (%) (n)  (%)Used 127 62 78 38 105 Not used 109 56 86 44 195 Total   400 P=0.001, DF=1, X2=9.6DiscussionIn the present study the prevalence of zinc defi­ciency in pregnant women was about 49%. In a study on the lactating mother in Indonesia the rate of zinc deficiency was 25% (10). The rea­son for this difference probably is due to nutri­tional regiment in these two regions. In Iran due to high consumption of fiber and little red meat, there is a high zinc deficiency comparing toother countries. A study on the micronutrition consumption among the pregnant women in Southeast Asia showed the prevalence of iron and folic acid deficiency as 50% and 30-50%, respectively (11). There was a study among the girl high school students in Zahedan done in 1999. The results from this investigation showed that prevalence of zinc deficiency among these girls is about 42.8% (9). Mahmoudi et al reported 65% zinc deficiency in a girl high school in Te­hran (12). The results of this study showed a meaningfuldifference as to prevalence of zinc deficiency in different age groups. The prevalence of zinc deficiency in age group of 20-30 years mother was higher than that of less than 20 years and the mothers more than 30 years had lower zinc deficiency than mothers in age group of 20-30 years. This may be due to higher requirement of zinc for younger age due to their growth age. The finding in this study indicates that the mother age more than 30 years have higher zinc deficiency than mother age 20-30 years. The reason is not clear. The prevalence of zincdeficiency in the different age of pregnancy showed meaningful difference, and that was due to mothers increasing requirement for zinc. Without a proper nutritional requirement the person falls in the state of zinc deficiency. The zinc level was determined according to thenumber of deliveries, and although we expected that with increasing the number of deliveries the prevalence of zinc deficiency worsen, but we did not find any significant difference. In this study zinc deficiency was not influenced by mothers' education level. This study indicated that iron consumption increased the zinc defi­ciency; this is probably due to effect of iron in prevention of intestinal zinc absorption. Acknowledgements This project was supported financially by the Zahedan University of Medical Sciences. The authors thank the university official and the Re­search Council of Medical School of this uni­versity. Mrs. Montazeri is thanked for her as­sistance in this research. The Chemistry groupof Sistan and Baluchestan University is thankedfor the determination of serum zinc concentra­tion, especially Dr Mirazaee. References  1. Burits CA, Ashwood ED (1994). Tietz textbook of clinical chemistry.2nd ed. 2. W.B Sanders, Sandstead HH (1991). Zinc deficiency, A public health problem?Am J Dischild, 145(8): 853-59. 17                           S Salimi et al: Study of Zinc… 3. Prasad AS (1961). Syndrome of iron defi­ciency, anemia, hepatic, hypogonadism, dwarfism and geophagia. Am J Med, 31:532-46. 4. Prasad AS (1963). Zinc metabolism inpa­tients, syndrome of iron deficiency ane­mia. Am J Lab Ed, 61:537. 5. Shah D, Sachdev HP (2001). Effect of gesta­tional zinc deficiency on pregnancy out­comes: summary of observation studies and zinc supplementation trials. Br J Nutr, 85 Suppl 2:S101-8. 6. Prasad AS (1998). Zinc in human health. J Trace Elem, 11:63-87. 7. Jameson S (1982). 	Zinc status and preg-nancy outcome in humans. First Edition, Alan R.Liss, 39-52 8. Osendarp SJ, Van Raaij JM, Darmstadt GL, Baqui AH, Hautvast JG, Fuchs GJ(2001). Zinc supplementation during pregnancy and effects on growth and morbidity in low birth weight infants a randomized placebo controlled trial.Lancet, 357(9262): 1080-85. 9. Karajibani M, Montazerifar F (1999). Epide­miological study of iron and zinc defi­ciency in high school girls in Zahedan. The Journal of medical faculty of Isfa-han, 56: 52-7. 10.	 Dijkhuizen MA, Wieringa FT, West CE, Muherdiyantiningsih M (2001). Concur­rent micronutrient deficiencies in lac­tating mothers and their infants in Indo­nesia. Am J Clin Nutr, 73(3): 786-91. 11.	 Seshadri S (2001). Prevalence of micro-nutrient deficiency particularly of iron, zinc, and folic acid in pregnant women in the Southeast Asia. Br J Nutr; 85 Suppl 2: 87-92. 12.	 Mahmoodi MR, Kimiagar SM (2001). Prevalence of zinc in junior high school students of Tehran city. Biol Trace Elem Res, 81(2): 93-103. 18

Study of zinc deficiency in pregnant women

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Study of zinc deficiency in pregnant women

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