Electrophoretic Pattern of Serum Proteins in Pregnancy: A Cross-sectional Study

Introduction: Nutritional status during pregnancy is a determining factor for maternal and neonatal health outcomes. Protein is an essential nutrient for foetal development. If pregnancy is associated with an improper diet leading to protein deficiency, the prospects for maternal and foetal outcomes may be catastrophic. An electrophoretic study of serum protein patterns in pregnancy can help identify pregnancy-specific protein markers and facilitate the monitoring of feto-maternal health. Aim: The aim of this study is to assess serum protein levels and their fractions (albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, and gamma globulin) using gel electrophoresis in healthy pregnant women attending an antenatal clinic. Materials and Methods: This cross-sectional study was conducted in the Department of Medical Biochemistry in collaboration with the Department of Obstetrics and Gynecology at Sultania Zanana Hospital, associated with Gandhi Medical College, Bhopal, Madhya Pradesh, India, between January 2021 and February 2021. Fifty normal non-pregnant women of childbearing age and 50 normal pregnant women in the first trimester of pregnancy attending an antenatal clinic were enrolled and followed-up through the second and third trimesters for investigations. Serum total protein, albumin, and globulin levels were estimated using a fully automated chemistry analyser, and the electrophoretic patterns of serum protein fractions were analysed using an automated gel electrophoresis apparatus. EpiInfo statistical software was used for the statistical analysis of data, with p<0.05 considered the statistical significance level. Results: The serum total protein level in non-pregnant women was 6.36 +/- 0.40 g/dL, while in pregnant women, it was 8.01 +/- 0.40 g/dL, 8.00 +/- 0.42 g/dL, and 6.36 +/- 0.43 g/dL in the first (T1), second (T2), and third (T3) trimesters, respectively. The serum albumin level was 3.90 +/- 0.30 g/dL in non-pregnant women, while in pregnant women it was 4.24 +/- 0.38 g/dL, 4.58 +/- 0.34 g/dL, and 3.87 +/- 0.36 g/dL in T1, T2, and T3, respectively. The globulin level in non-pregnant women was 2.46 +/- 0.28 g/dL, while in T1, T2, and T3 it was 3.86 +/- 0.22 g/dL, 3.42 +/- 0.20 g/dL, and 2.49 +/- 0.24 g/dL, respectively. A significant difference was found among the groups for serum total protein, serum albumin, and serum globulin. In non-pregnant women, the protein fractions- albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, and gamma globulin- did not show any deviation from normal levels. However, there was a decrease in albumin and beta globulin levels, along with an increase in alpha-2 globulin levels in the first trimester. An increase in beta globulin and a decrease in gamma globulin levels were observed in the second trimester. In the third trimester, all these fractions did not show any significant alterations, except for gamma globulin. Conclusion: Serum total protein, serum albumin, and serum globulin levels showed a significant difference. However, a slight increase in serum globulin levels compensated for the fall in albumin levels during pregnancy. Variations in the levels of beta globulin, alpha-2 globulin, and gamma globulin were observed during pregnancy, while, on the other hand, alpha-1 globulin did not show any alterations in pregnant women during the first, second, and third trimesters, although its level was higher in pregnant women compared to non-pregnant women.