SARS CoV-2 is a novel coronavirus which has caused many deaths in the recent pandemic. This study aimed to determine zinc, copper and magnesium status on pregnant women with COVID-19. 100 healthy (33/32/35) and 100 SARS-CoV-2 positive (34/33/33) pregnant women were included in the study according to their trimesters. Blood samples were obtained from the patients along with the initial laboratory tests for clinical outcomes upon their first admission to hospital. In the first and third trimesters serum zinc level was lower (p:0,004 and p:0,02), serum copper level was higher (p:0,006 and p:0,008), the Zn / Cu ratio decreased(p < 0.0001 and p < 0.0001) and the serum magnesium level was higher(p < 0.0001 and p < 0.0001) in the COVID-19 group.In the second trimester COVID-19 patients had lower serum zinc (p:0,05) and copper levels (p:0,0003) compared to controls. Disease severity correlated with zinc/copper ratio in COVID19 patients (p:0.018, r:-0.243). Serum zinc and Zn/Cu ratio levels had a negative relationship with acute phase markers such as IL-6, Erythrocyte Sedimentation Rate, procalcitonin and C-reactive Protein. Also, increased serum magnesium level may play a role in decreased white blood cell, neutrophil, lymphocyte cell count and increased CRP levels in the third trimester. This study indicated that trace element status changed in pregnant women with COVID-19. The effect of trace elements on pregnant women diagnosed with COVID-19 infection was investigated in comparison with healthy pregnant women for the first time. This effect will be revealed better in more comprehensive studies to be planned in the future.

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The Relation Between Trace Element Status (Zinc, Copper, Magnesium) and Clinical Outcomes in COVID-19 Infection During Pregnancy.

Iron (Fe), copper (Cu), and zinc (Zn) are microelements essential for the proper functioning of living organisms. These elements participatein many processes, including cellular metabolism and antioxidant and anti-inflammatory defenses, and also influence enzyme activity, regulate gene expression, and take part in protein synthesis. Fe, Cu, and Zn have a significant impact on the health of pregnant women and in the development of the fetus, as well as on the health of the newborn. A proper concentration of these elements in the body of women during pregnancy reduces the risk of complications such as anemia, induced hypertension, low birth weight, preeclampsia, and postnatal complications. The interactions between Fe, Cu, and Zn influence their availability due to their similar physicochemical properties. This most often occurs during intestinal absorption, where metal ions compete for binding sites with transport compounds. Additionally, the relationships between these ions have a great influence on the course of reactions in the tissues, as well as on their excretion, which can be stimulated or delayed. This review aims to summarize reports on the influence of Fe, Cu, and Zn on the course of single and multiple pregnancies, and to discuss the interdependencies and mechanisms occurring between Fe, Cu, and Zn.

The Role of Fe, Zn, and Cu in Pregnancy.

Increasing numbers of individuals may be exposed to nanomaterials during pregnancy. The overarching goal of this investigation was to determine if prenatal inhalation exposure to copper nanoparticles (Cu NPs) has an effect on dams and offspring, including an analysis of inflammatory markers (Th1/Th2 cytokine profiles). Physicochemical characterization of Cu NPs was performed. Pregnant and non-pregnant mice (C57Bl/6 J) were exposed to Cu NPs or laboratory air in the whole-body chamber for 4 hrs/day on gestation days (GD) 3–19 (3.5 mg/m3). Animals were euthanized on GD 19 (0 week) or 7 weeks later. Bronchoalveolar lavage (BAL) fluid was analyzed for total and differential cells. Cytokine/chemokine concentrations were determined in the BAL fluid and the plasma of dams/non-pregnant mice and pups. Cu content was determined in the lungs and the blood of dams/non-pregnant mice and pups, in the placentas as well as in the whole bodies of pups immediately after delivery. Lungs and placentas were evaluated for histopathological changes. Gene expression of the Th1/Th2 profiles were analyzed in spleens of pups. The survival rate of 7 week old pups exposed to Cu NPs was significantly lower than control pups (73 vs. 97 %). The average litter size, male/female ratio, body weight and lenght at birth were not different between Cu NP-exposed and control mice. Both pregnant and non-pregnant mice exposed to Cu NPs had significant pulmonary inflammation with increased number of neutrophils in the BAL fluid compared to controls. Perivascular lymphoplasmacytic cuffing was found in the lungs of exposed mice and was more pronounced in the non-pregnant group. Similarly, levels of inflammatory cytokines/chemokines IL-12(p40), G-CSF, GM-CSF, KC, MCP-1, MIP-1α, MIP-1β, RANTES and TNF-α in BAL fluid were significantly higher in non-pregnant than pregnant exposed mice. Histopathology evaluation of placentas did not identify any pathological changes. No translocation of Cu into the placenta or the fetus was found by inductively coupled plasma-mass spectroscopy. Expression of several Th1/Th2 or other immune response genes in pups’ spleens were found to be significantly up- or down-regulated. Prenatal exposure to Cu NPs caused a profound pulmonary inflammation in dams and strong immunomodulatory effects in offspring. There was no clear polarization of genes expressed in pups’ spleens towards Th1 or Th2 type of response.

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Effects of prenatal inhalation exposure to copper nanoparticles on murine dams and offspring

OBJECTIVE Lack of trace elements during pregnancy is detrimental to maternal and fetal health. Our aim is to study the changes in trace element levels in Chinese pregnant women and their association with adverse pregnancy outcomes. PATIENTS AND METHODS 1568 cases of Chinese pregnant women in remote areas were collected for a prospective cohort study. Serum copper, zinc, calcium and iron levels were measured at pre-pregnancy, 1st trimester (7w-12w), 2nd trimester (24w-28w) and 3rd trimester (35w-40w). RESULTS (1) Serum copper levels was significantly higher after pregnancy than before, calcium and iron levels decreased, but zinc levels did not change significantly. (2) Copper and zinc deficiency in pregnant women was not a common finding, but lack of iron and calcium was frequently encountered; iron deficiency was especially common in the 3rd trimester (42.27%). (3) Serum zinc and iron levels in patients who either had a miscarriage or a preterm delivery were significantly lower than in the control group (p < 0.05). In patients with premature rupture of membranes, serum zinc levels were significantly lower (p < 0.05). In patients with intrauterine growth restriction (IUGR), serum copper, zinc, calcium and iron were significantly lower (p < 0.05). CONCLUSIONS Trace elements is closely associated with fetal growth and development during pregnancy. Deficiency can lead to adverse pregnancy outcomes. Therefore, we should have a reasonable diet, replenish trace elements, therefore reducing the occurrence of adverse pregnancy outcomes.

Four trace elements in pregnant women and their relationships with adverse pregnancy outcomes.

BACKGROUND
The purpose of the study was to examine racial/ethnic differences in cervical insufficiency risk.

Health disparities in risk for cervical insufficiency

Introduction. Copper is essential micronutrient and has an important role in
 the human body. The serum copper increases during pregnancy and is doubled at
 full term. Lower levels of serum copper in pregnancy are connected with some
 pathological conditions. Objective. The aim of this study was to estimate the
 levels of serum copper in normal and pathological pregnancies, comparing them
 with values of serum copper in non-pregnant women, to determine if serum
 copper is lower in some pathological pregnancies and if this is of some
 importance. Methods. A total of 2170 plasma samples for copper analyses were
 made in the following groups: healthy non-pregnant women; healthy pregnant
 women from the 5th-40th gestational week, during the first delivery stage and
 during the first three postpartum weeks, in pregnant women with habitual
 abortion, imminent abortion, abortion in progress, missed abortion (9th-24th
 weeks), missed labour and premature rupture of membranes (29th-40th weeks).
 Levels of serum copper were determined by colorimetric technique of
 bathocuproin with disulphate as a chromogen. Results. Serum copper values in
 non-pregnant women range from 11.6-25.8 μmol/L. In healthy pregnant women,
 there is a constant trend of the increase of serum copper. The mean serum
 copper values revealed three significant peaks at the 22nd, 27th and 35th
 gestational week. Serum copper values in the patients with some pathological
 pregnancies in relation to the serum copper values of the healthy pregnant
 women were significantly lower. Conclusion. Serum copper values can be used
 as an indicator of some pathological pregnancies.

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Variations of serum copper values in pregnancy.

Introduction. Head posture in relation to the cervical spine is correlated with the morphology of the face and jaw, the position and the mutual relationship of the maxilla and mandible, their length and inclination. The aim of this study is to examine the relationship between the head posture and parameters of the sagittal position and length of the jaws. Material and Methods. The study included 90 subjects (30 for I, II and II skeletal class each) between the ages of 8 and 14 years, who were examined at the Department of Dentistry of Vojvodina in Novi Sad. Each subject had the lateral cephalogram made, and the analysis was performed by means of the computer program 'Onyx Ceph.' The following parameters were analyzed: craniocervical angle, angle of maxillary prognathism, angle of mandibulary prognathism, the difference angles of maxillary and mandibulary prognathism, length of maxillae, and length of mandible. Results. The angle of maxillary prognathism was in positive correlation with the craniocervical angle in the patients with class I and II, and they were negatively correlated in the patients with class III. The angle of mandibulary prognathism was in positive correlation with the craniocervical angle in the patients with class I and III, but they were negatively correlated in the patients with class II. The patients with class II had a statistically significant positive correlation between the craniocervical angle and length of the maxilla, and a significant, but negative correlation between the craniocervical angle and length of the mandible. Conclusion. Increased extension of the head in relation to the cervical spine can be a contributing factor to the formation of class II malocclusion.

https://scindeks-clanci.ceon.rs/data/pdf/0025-8105/2016/0025-81051610288V.pdf

Relationship between head posture and parameters of sagittal position and length of jaws.

The cervical length is an important factor in the risk evaluation of preterm delivery. The aim of this work was to determine the correlation between the cervical length and the demographic characteristics. A transversal type prospective study was done on a sample of 579 pregnant women at various gestational age of low risk mono-fetal pregnancy. The cervical length was measured by trans-vaginal ultrasound procedure within the regular pregnancy monitoring process. The following data were taken into consideration: the woman's age, her body mass at the beginning of the pregnancy and her height in order to calculate the body mass index as well as her smoking habit at the moment of conception. The mean cervical length was 34.3 mm and 35 mm in the group of women aged 30 and less and 31 and over, respectively. The cervix was insignificantly shorter in younger women (being 34.9 mm/35.9 mm in the 1st trimester, 34.5 mm/35.1 mm in the 2nd one and 33.9 mm/34.7 mm in the 3rd trimester). The sample of 579 pregnant women consisted of 448 non-smokers and 131 smokers. The difference in the length of the cervix in smokers and non-smokers was not significant (being 32.2 mm/35.9 mm; 35 mm/34 mm and 34.4 mm/33.5 mm in the 1st, 2nd and 3rd trimester, respectively). The correlation between the body mass index and the cervical length was analyzed by trimesters. In the first trimester the increase in the body mass index was followed by the shortening of the cervix; the cervical length was not affected by the BMI in the second trimester, whereas the higher the body mass index the longer the cervix in the third trimester. Our study has shown that the cervical length is affected neither by the age of the woman nor her smoking habit but it is affected by the body mass index at the moment of conception, that linear trend being negative in the 1st trimester but positive in the 3rd one. Since the cervical length may be affected not only by the socio-demographic characteristics but the gynecologic obstetric history of the woman as well, we strongly suggest further investigations in this field.

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Socio-demographic factors and cervical length in pregnancy.

Introduction. Normal occlusion or eugnathia, is a morphologically and functionally balanced bite. Differences in the form and function of orofacial structures cause morphological and functional deviations of the orofacial system. Irregular occlusal positions may consequently change the electromyographic activity of the muscles of orofacial region. The aim of the research was an analysis and a comparative analysis of the bioelectrical activity of masticatory muscles in normal occlusion and distocclusion, in rest position, in the position of the central occlusion of the mandible and at the maximum voluntary muscle contraction. Material and methods. The metodology of the research is based on electromyographic recording of the action potentials of the examined muscles in different mandibular positions. Registration of action potentials of the masticatory muscles was done using, facial, intramuscular, and coaxial electrodes, (Greenfield scheme) and measurements were performed on both sides. The research was carried out on a sample of 60 patients with an average age of 14,25 years. 30 subjects had normal occlusion and 30 had distal occlusion. Results. The results were expressed in microvolts, as average cumulative amplitude voltages of action potentials, by means of which changes in the masticatory muscles were established and the degree of correlation between the electromyographic activity of the masticatory muscles and the occlusal type was analyzed. Conclusion. The results of the research show that the bioelectrical activity of the examined masticatory muscles falls in the group of subjects with distal occlusion, which is the result of a decreased number of active muscular tissues, or a decreased number of impulses coming into the muscle, or the combination of both. .

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Electromyographic activity of the temporal and masseter muscles at different occlusal positions

Introduction. The cervical length is a predictor of premature delivery or abortion. In order to detect the risks of such complications, it is necessary to establish the factors affecting the length of the cervix. Material and methods. A transversal prospective study was carried out in a sample of 579 pregnant women with low risk, singleton pregnancies of various gestational ages. Cervical length was measured by transvaginal ultrasound as part of routine pregnancy monitoring. At the same time, data on previous first-trimester or mid-trimester abortions, as well as on premature deliveries and term deliveries, were collected and taken into consideration. Results. The cervical length in primiparous women was not statistically significantly longer than in women with a previous pregnancy, except during the second trimester, (primiparous women: 33.8 mm. women with a previous pregnancy: 35.8 mm). Bearing in mind the empirical facts that the cervix in primiparous women. since intact, is significantly longer, the above mentioned findings cannot be easily explained. The cervix in women with a previous vaginal delivery was statistically significantly longer (35.6 mm) than in women with no vaginal delivery (34.09) (p=0.0l 1). In women with previous abortions of any kind, the cervical length was 34.2 mm. The cervical length in women without previous abortions was 34. 7 mm, and there were no significant differences. Moreover, no statistically significant differences were established in women with or without previous abortions, regardless of the type. Conclusion. Taking into consideration the data from previous obstetric histories, the results of our study indicate that cervices of women. .

/pdf/previous-obstetric-history-and-cervical-length-in-pregnancy-3iwfhpif1a.pdf

Djordje Petrovic

Papers

Variations of serum copper values in pregnancy.

Relationship between head posture and parameters of sagittal position and length of jaws.

Socio-demographic factors and cervical length in pregnancy.

Electromyographic activity of the temporal and masseter muscles at different occlusal positions

Previous obstetric history and cervical length in pregnancy