{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:26:07Z","timestamp":1786965967198,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anemia in pregnancy is traditionally attributed to iron deficiency, but emerging evidence highlights the contribution of other trace elements to hematopoiesis and oxidative defense. Limited studies from India have systematically evaluated their multivariate interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study assesses serum concentrations of eight trace elements in anemic and non\u2010anemic pregnant women and identifies latent clustering patterns using principal component analysis (PCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This hospital\u2010based cross\u2010sectional study enrolled 100 pregnant women (&lt;\u200914\u2009weeks gestation) at a tertiary care center in Lucknow, India. Serum concentrations of iron (Fe), zinc (Zn), copper (Cu), selenium (Se), magnesium (Mg), manganese (Mn), cobalt (Co), and chromium (Cr) were measured using inductively coupled plasma mass spectrometry. Data were analyzed using independent\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, Pearson's correlation, and PCA with exploratory factor analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Anemic women had significantly lower serum Fe (43.10\u2009\u00b1\u200926.47\u2009\u03bcg\/dL) compared to controls (77.88\u2009\u00b1\u200937.71\u2009\u03bcg\/dL,\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.001). Hemoglobin correlated positively with Fe (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009+0.590,\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.01) and weakly, negatively with Cu (\n                      <jats:italic>r\u2009=<\/jats:italic>\n                      \u2009\u22120.201,\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.05). PCA revealed four clusters explaining 70.7% of variance: Fe\u2013Zn\u2013Se, Mn\u2013Cr, Mg\u2013Co, and Cu. These clusters suggest synergistic and competitive roles of trace elements in red cell metabolism beyond iron deficiency alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Iron deficiency remains the predominant cause of anemia in pregnancy. However, PCA underscores the collective influence of trace element clusters, highlighting potential secondary modulators of anemia risk. Broader micronutrient\u2010based strategies, alongside iron supplementation, might improve maternal anemia outcomes in India.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71299","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:49:38Z","timestamp":1786963778000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multivariate patterns of trace elements in anemia during pregnancy: Insights from principal component analysis in a hospital\u2010based study from North India"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0751-2865","authenticated-orcid":false,"given":"Hadiqa","family":"Hilal","sequence":"first","affiliation":[{"name":"Department of Obgyn Era's Lucknow Medical College and Hospital  Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2324-158X","authenticated-orcid":false,"given":"Ayesha","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Obgyn Career Institute of Medical Sciences and Hospital  Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3241-6484","authenticated-orcid":false,"given":"Suman","family":"Nishad","sequence":"additional","affiliation":[{"name":"Department of Obgyn Career Institute of Medical Sciences and Hospital  Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Faheem","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Era University Lucknow  Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"National Family Health Survey (NFHS\u20105), India Report 2019\u201321","author":"International Institute for Population Sciences (IIPS) and ICF","year":"2021"},{"key":"e_1_2_10_3_1","volume-title":"National Family Health Survey (NFHS\u20105), Uttar Pradesh Fact Sheet 2019\u201321","author":"International Institute for Population Sciences (IIPS) and ICF","year":"2021"},{"issue":"9","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.5603\/GP.a2017.0093","article-title":"Selected trace elements concentrations in pregnancy and their possible role \u2014literature review","volume":"88","author":"Lewicka I","year":"2017","journal-title":"Ginekol 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Vadodara","volume":"6","author":"Sheth N","year":"2020","journal-title":"Int J Innovative Res Multidiscip Field"},{"issue":"8","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"2056","DOI":"10.1111\/jog.15705","article-title":"The association between maternal iron, zinc, copper levels in serum and pregnancy outcomes","volume":"49","author":"Wang L","year":"2023","journal-title":"J Obstet Gynaecol Res"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2023.1086082"},{"issue":"2","key":"e_1_2_10_11_1","first-page":"1","article-title":"A comparative study of plasma trace elements (copper, iron and zinc) status in anemic and non\u2010anemic pregnant women in Abakaliki, Nigeria","volume":"10","author":"Ugwuja EI","year":"2011","journal-title":"Online J Health Allied 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