The aim of this prospective case-control study was to determine the change in serum maternal ischemia-modified albumin (IMA) during normal pregnancies. A total of 117 pregnant (first trimester (n=24), second trimester (n=34), and third trimester (n=35)) and non-pregnant healthy women (n=23) were included. Maternal serum IMA, Malondialdehyde (MDA), and albumin levels were measured. Compared with non-pregnant women, the cross-sectional mean IMA levels in pregnant women were significantly increased, while the mean serum MDA and albumin levels were significantly decreased throughout pregnancy. Furthermore, a significant negative correlation between serum IMA and albumin levels (r=-0.354, p0.001) was found, and there was a weak positive correlation between serum albumin and MDA levels (r=0.334, p0.001). Serum IMA, which has recently been developed as a clinical marker of ongoing myocardial ischemia, appears to be elevated in normal pregnancy. This may be due to the physiologic oxidative stress state of pregnancy.