Maternal Serum Zinc and Copper Levels in Early Pregnancy and their Association with Fetal Growth Restriction

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 373–384

DOI: 10.46882/2026/IJOG/000508

Original Research Article

Title: Maternal Serum Zinc and Copper Levels in Early Pregnancy and their Association with Fetal Growth Restriction

Names of Authors: Bukola R. Omotayo¹, David C. Iwuala¹

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria

Abstract:
Trace elements play essential structural and catalytic roles in placental development and embryonic cellular proliferation. This prospective observational study evaluated the relationship between first-trimester maternal serum concentrations of zinc (Zn) and copper (Cu) and the subsequent development of Fetal Growth Restriction (FGR) in low-risk singleton pregnancies. Serum samples were collected from 600 pregnant women between 11 and 13⁺⁶ weeks of gestation, and trace element concentrations were quantified via inductively coupled plasma mass spectrometry. All participants were followed longitudinally until delivery. FGR was defined postnatally as a customized birth weight below the 10th percentile. Sixty-eight pregnancies (11.3%) were complicated by FGR. First-trimester maternal serum zinc levels were significantly lower in the FGR group compared to normotensive, appropriate-for-gestational-age controls (58.4 ± 12.2 μg/dL vs. 74.6 ± 14.5 μg/dL, p < 0.001). Conversely, the mean copper concentration and the Cu/Zn ratio were significantly elevated in the FGR cohort (Cu/Zn: 2.15 ± 0.45 vs. 1.42 ± 0.32, p < 0.001), indicating altered antioxidant balance. Adjusting for maternal age, smoking status, and BMI, logistic regression analysis revealed that maternal zinc levels below 60 μg/dL were associated with a fourfold increase in FGR risk (OR = 4.12; 95% CI, 2.18 to 7.82, p < 0.001). Low maternal serum zinc levels and an elevated Cu/Zn ratio in the first trimester are strongly associated with impaired fetal growth, highlighting potential targets for early nutritional assessment.

Keywords: Fetal Growth Restriction; Zinc Deficiency; Copper; Trace Elements; Placental Development; Nutritional Biomarkers.

Manuscript Timeline: Received: May 28, 2026; Revised: July 16, 2026; Accepted: August 05, 2026; Published: August 21, 2026.

Citation: Omotayo BR, Iwuala DC. Maternal Serum Zinc and Copper Levels in Early Pregnancy and their Association with Fetal Growth Restriction. International Journal of Obstetrics and Gynecology. 2026; 14(8): 373–384.

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