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Preeclampsia is the main cause of maternal and perinatal death. Multiple studies suggest that trace elements were associated with preeclampsia, but the results varied, and less known about early or mid-term pregnancy of trace elements and preeclampsia. We aim to explore the association between mid-term pregnancy trace elements levels and preeclampsia. The retrospective cohort study was consecutively conducted in Foshan Fosun Chancheng Hospital, Guangdong Province, China, from August 1, 2019, to November 30, 2019. Trace elements are derived from the laboratory data system, measured in maternal whole blood during 12–27 (+6) weeks of pregnancy by flame atomic absorption spectrometer method. Preeclampsia diagnosis and covariance were ascertained from the electronic medical records system. We used multivariable logical regression to estimate odds ratios (OR) and 95% CIs. A total of 2186 participants were included in this study, and 59 (2.70%) women developed preeclampsia. After multivariable adjustment, the OR of Mg levels for preeclampsia was 0.35 (95%CI:0.06,2.20). The fifth quintiles of Mg were associated with 0.29 (95% CI：0.10,0.85) times lower risk of preeclampsia compared with the first quintile, with a dose-response trend (P for trend = 0.056). Per 1 µmol/L increment in Cu was associated with 11% lower risk of preeclampsia (OR=0.89; 95% CI, 0.78,1.02). Compared with the first quintile, the second, third，fourth，fifth quintile of Cu was associated with a odd ratio of 0.12 (95% CI:0.03,0.43),0.67 (95% CI:0.30,1.48),0.33 (95% CI:0.15,0.76) and 0.26 (95% CI:0.10,0.66),respectively. Null associations were observed for Zn, Fe, Ca. Higher blood Mg and Cu levels in mid-term pregnancy were associated with lower preeclampsia risk. • Multiple studies suggest that trace elements were associated with preeclampsia, but the results varied. • Less known about early or mid-term pregnancy of trace elements and preeclampsia. • Higher blood Mg and Cu levels in mid-term pregnancy were associated with lower preeclampsia risk. [ABSTRACT FROM AUTHOR]

Preeclampsia is the main cause of maternal and perinatal death, especially in developing countries. Multiple studies suggest that blood lead levels in pregnancy are a risk factor for preeclampsia, even with low levels of blood lead. But less knows the dose-effect relationship of preeclampsia in low blood lead levels. This study aims to assess the association between blood lead levels and preeclampsia and to explore its dose-effect relationship between low blood lead levels and preeclampsia. The retrospective cohort study was consecutively conducted in a comprehensive tertiary hospital in Foshan city of Guangdong Province, China, from August 1, 2019, to November 30, 2019. Blood lead levels were measured in maternal whole blood in 12–27 (+6) weeks of pregnancy, using atomic absorption spectrometer. Preeclampsia diagnosis was ascertained from the electronic medical records system. The risk of preeclampsia was estimated by multivariable logical regression analysis, and a two-stage linear regression model was established to find out the dose-effect. A total of 2174 people were included in this study, and 59 (2.7%) women developed preeclampsia. The dose-effect analysis revealed a non-linear association between blood lead levels and the risk of preeclampsia, with a cut-off point at 4.2 μg/dl. When blood lead levels were over 4.2 μg/dl, the risk of preeclampsia increased significantly with an increase in blood lead levels (OR = 2.05, 95%CI: 1.50, 2.81). In the multivariate regression models, per 1 μg/dl increment in blood lead levels was associated with 43% higher risk of developing preeclampsia (OR = 1.43,95%CI:1.17,1.74). Moreover, the association between blood lead levels and preeclampsia was stable in different subgroups. Low levels of lead exposure had a dose-effect relationship of preeclampsia, with a cut-off point at 4.2 μg/dl. Blood lead levels had a non-linear association with preeclampsia. When the blood lead levels were higher than 4.2 μg/dl, the risk of preeclampsia increases by 105% for every 1 μg/dl increase in blood lead levels. • Lead exposure remains a risk factor for maternal health. But less knows the dose-effect relationship of preeclampsia in low blood lead levels. • Low blood lead levels had a non-linear and a dose-effect relationship of preeclampsia, with a cut-off point at 4.2 µg/dl. • When blood lead levels were higher than 4.2 µg/dl, the risk of preeclampsia increases by 105% for per 1 µg/dl increase in blood lead levels. [ABSTRACT FROM AUTHOR]