Association of Toxoplasma gondii Infection with Serum Copper, Iron, and Vitamin C Levels in Women with Recurrent Spontaneous Abortion in Babylon Province, Iraq

Abstract

Background: One of the factors contributing to poor pregnancy outcomes, such as recurrent spontaneous abortion (RSA), is toxoplasma gondii infection. Micronutrient and antioxidant disorders—levels of a particular nutrient or a physiologic molecule's capacity to withstand oxidation, such as in copper (Cu), iron (Fe), and vitamin C—may increase the risk of pregnancy loss because of oxidative stress, inflammation brought on by infection, and placental dysfunction. Objectives: This study has investigated the serum Cu, Fe, and vitamin C levels of women with RSA and serological evidence of T. gondii infection in Babylon Province in Iraq and their comparison with healthy people. Materials and Methods: A case-control study was done in Babylon Maternity and Children's Hospital during the period of October 2025 to January 2026. A total of 100 women were recruited; 50 cases (RSA with T. gondii seropositivity) and 50 controls (no history of abortion and T. gondii seronegativity) were included. Anti-T. gondii IgG and IgM antibodies were determined by means of indirect immunodiffusion and enzyme immunoassay. Serum Cu and Fe levels were measured by atomic absorption spectrophotometry, and vitamin C was measured using the 2,4-dinitrophenyl hydrazine (DNPH) colorimetric method. Data analysis was performed using an independent-samples t-test and Pearson correlation. p<0.05 was considered significant. Results: Among the cases, the serological positive results were observed for 18/50 (36%) and 32/50 (64%) for IgM and IgG, respectively, whereas in the controls, all the results were negative (p < 0.001). Serum Cu was significantly higher in cases than controls (125.64 ± 18.72 vs 112.41 ± 16.85 ug/dL; P = 0.001). Serum Fe level was significantly low in cases (61.73 ± 10.48) vs (87.92 ± 13.31) micro gram/dL; p < 0.001). Vitamin C was also significantly decreased in cases (0.69±0.14 vs 1.11 ± 0.19 mg/dL; p< 0.001). In the case group, Cu had a negative correlation with Fe (r = -0.48; p = 0.003) whereas Fe had a positive correlation with vitamin C (r = 0.59; p < 0.001). Conclusions: Women with RSA and T. gondii infection were found to have higher concentrations of copper and lower concentrations of iron and vitamin C, indicating an infection-associated inflammatory and oxidative milieu, which can possibly lead to loss of pregnancy.