The Bottom Line

Although copper is assessed to be critical for fetal brain development, not much is known about copper and its requirements during pregnancy.

Currently, supplementation is not recommended, as women should be able to obtain all copper necessary during pregnancy through a varied diet.

However, research is ongoing regarding copper’s relationship with iron and anemia, a common condition during pregnancy, and how copper levels may contribute to its development of anemia.

Pregnant women should never take supplements without speaking to their health care provider (HCP) first.

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Background

Copper is required for iron absorption, the carrying of oxygen through the blood, and the production of elastin and collagen needed by the bones, cartilage, and tendons.

Pregnancy

Copper deficiency and its effects on pregnancy and fetal development has not been well studied, but there is some evidence it is important for brain development through the formation of neurotransmitters.

Photo by Jonathan Borba on Unsplash

Although data is very limited, copper concentrations in the blood during pregnancy appear to significantly increase and may even be double at term.

Estrogen appears to increase the amount of copper in the body, which may have a direct effect on pregnancy, indicating the body absorbs more of the mineral during this time.

A full-term fetus contains about 13.7 to 17 milligrams (mg) copper (higher than adults); the placenta and amniotic fluid also contain copper.

For pregnant women, an increment of 0.2 mg/day is estimated to cover the amount of copper deposited in the fetus and the placenta over the full course of pregnancy.

Deficiency

The metabolism of copper and iron are tightly linked during pregnancy. Iron cannot leave its storage in the body if copper levels are low. It is theorized that because anemia is common during pregnancy, and some women do not respond to iron supplements, low copper levels should be taken into account as a contributing factor.

However, it is unclear exactly what constitutes deficiency of copper during pregnancy, and mild deficiency may not have adverse outcomes. Despite this, some negative effects have been linked to "deficiency" in pregnancy:

In the first trimester of pregnancy, copper deficiency has been linked to miscarriage and anembryonic pregnancy (formerly called blighted ovum).

Animal studies have shown that copper deficiency in the mother produces effects ranging from intrauterine growth restriction to fetal death (animal studies do not always correlate to humans).

Note: High supplements of zinc (50 mg/day or more) for extended periods of time may result in copper deficiency (11 mg/day of zinc is recommended during pregnancy).

Supplementation

It is recommended pregnant women receive 800 to 1,500 mcg/day of copper; adult women in the United States are estimated to consume 1,100 mcg/day of copper through food, well within the recommended range.

The Tolerable Upper Intake level for adults is 10,000 mcg/day (10 mg/day), based on protection from gastrointestinal symptoms and liver damage, which can occur through chronic excess copper intake. Copper does not appear to interact with any medication.

At least one study identified a decrease in depressive symptoms in pregnant women in the second and third trimesters who were supplemented with copper, but more research is needed to explain how or why.

Food Sources

Good sources of copper include: sesame seeds, potatoes, cashews, sunflower seeds, mushrooms, chickpeas, crab, turkey, chocolate, tofu, avocado, salmon, figs, and spinach.

Although beef liver has one of the highest concentrations of copper, it is recommended in limited amounts during pregnancy due to its high amount of vitamin A.

Action

Women who are concerned about their copper intake during pregnancy, especially those with malabsorption disorders, should have a discussion with their HCP.

Women who may be exposed to excess copper though drinking water may wish to have their well water tested (see Resources).

Resources

Copper Fact Sheet (U.S National Institutes of Health)

For more information regarding drinking water and having a well tested for copper levels and other contaminants, visit the below links or call the local health department or the EPA Safe Drinking Water Hotline at (800) 426-4791.

o   Private Drinking Water Well Programs in Your State

o   Laboratories that Analyze Drinking Water Samples

References

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