Association between zinc, copper, iron, calcium, magnesium, and preeclampsia development: a narrative review

Preeclampsia is defined as hypertension and proteinuria or as hypertension and end-organ dysfunction with or without proteinuria, typically presenting after 20 weeks of gestation. This condition remains a leading cause of fetal and maternal morbidity worldwide. Its pathogenesis is associated with detrimental processes such as endothelial dysfunction, oxidative stress, and inflammation. The regulation of immune system activity, vascular health, and oxidative stress mitigation is influenced by minerals, which play a key role in pregnancy. Examples include zinc, copper, iron, calcium, and magnesium. This narrative review aimed to establish a possible connection between the concentrations of these minerals in various biological samples (serum, urine, placenta, and plasma) and the development of preeclampsia. Elevated dietary intake of these metals and the association between mineral intake and the risk of preeclampsia development were also considered. A literature search was conducted in scientific databases, including ScienceDirect and PubMed, to address the research question to collect relevant studies published between 2014 and 2024. Evidence suggests that mineral status disturbances may contribute to oxidative stress, endothelial damage, and inflammatory imbalance in preeclampsia. Specifically, zinc deficiency exacerbates oxidative stress, while higher copper concentrations are associated with increased oxidative damage. Elevated iron levels in both the diet and serum have been shown to contribute to ferroptosis through the generation of reactive oxygen species. Additionally, calcium and magnesium deficiencies have been reported to impair blood pressure regulation and vascular tone. The association between minerals and preeclampsia is complex and depends on multiple factors, including race, location, gestational age, maternal age, diet, and ratios between elements.