Background: Preeclampsia at molecular and cellular levels was observed as a disease of placentation that is affected by
interaction of various factors that could trigger the disease pathological course and behavior. Prenatal environmental metals
exposure is considered a cornerstone factor that could trigger the clinical presentation of preeclampsia due to toxic effects of some
trace metals, besides the deficiency of some trace elements is considered a crucial issue in cell apoptosis and remodeling is one of
the characteristic features of trophoblastic invasion.
Aim: To investigate the predictability value of trace metal screening in predictability of preeclampsia clinical development.
Methodology: The current research clinical trial is prospective in manner that recruited 420 research study subjects from
January 2017 till April 2019 ,inclusive research criteria were singleton gestations with no congenital fetal anomalies all recruited
research study subjects had full clinical history taking and examination during antenatal visits urinary samples obtained during
10th till 15th gestational weeks were assessed for the trace metal profile investigated and angiogenic markers. Urine samples were
collected at 10th till 15th gestational weeks and stored at − 80 °C until analysis after delivery, preeclampsia diagnosis and diagnosis
date were abstracted from medical records. Preeclampsia was clinically defined as elevated maternal blood pressure (>140mmHg
systolic and/or >90mmHg diastolic) and proteinuria (>300 mg/24 h or a protein/creatinine ratio >0.20) after 20 gestational weeks.
Results: Cr chromium at Cut off point >0.92 have AUC= 0.747, statistical Sensitivity= 80.0, statistical Specificity=60.8, PPV=13.6,
NPV =97.5, Se selenium at cutoff point ≤ 35.4 have AUC= 0.759, statistical Sensitivity=83.3, statistical Specificity=62.6, PPV=14.6,
Conclusion: The current study provokes the clinical value for trace metal screening in detectability of preeclamptic risk of
development, however future research efforts are requiring correlating the clinical risk of disease development according to the
environmental trace metal levels.