Hjollund N H, Bonde J P, Ernst E, Lindenberg S, Andersen A N, Olsen J
Department of Occupational Medicine, Aarhus University Hospital, DK-8000, Aarhus, Denmark.
Hum Reprod. 2005 Jul;20(7):1793-7. doi: 10.1093/humrep/deh680. Epub 2005 Mar 10.
Fume from welding of stainless steel contains hexavalent chromium, which in animal studies can induce paternally mediated spontaneous abortion. Human studies have shown conflicting results. The best studies include early pregnancy experience, but these are expensive to conduct. In vitro fertilization (IVF) provides new design opportunities. Our aim was to study pregnancy survival in IVF treated women with respect to paternal welding exposure.
We mailed a questionnaire to 5879 couples from the Danish IVF register that covers all IVF treatments after 1993 (response ratio 68.2%). A subgroup of male metal workers received a second questionnaire on exposure to welding (n = 319 men, response ratio 77%). Information on outcome was collected from national health registers. Survival of the first hCG-positive pregnancy was analysed using Cox regression.
The proportion of pregnancies terminated by spontaneous abortion before 28 gestational weeks was 18% (n = 91 pregnancies) and 25% (n = 128) in pregnancies with paternal exposure to stainless steel welding and mild steel welding, respectively. In the reference group of 2925 pregnancies the abortion ratio was 28%. The risk ratio for pregnancies with paternal exposure to stainless steel was 0.6 (95% CI 0.4-1.0).
We found no increased risk of spontaneous abortion in IVF treated women, who became pregnant by a man exposed to welding of any sort. Since the process of fertilization and selection of IVF pregnancies differs from natural pregnancies the negative results need not apply to other pregnancies.
不锈钢焊接产生的烟雾中含有六价铬，动物研究表明其可导致父源性自发流产。人体研究结果存在矛盾。最佳研究纳入了早期妊娠经历，但开展此类研究成本高昂。体外受精（IVF）提供了新的研究设计机会。我们的目的是研究接受IVF治疗的女性中，父亲有焊接暴露史时的妊娠存活情况。
我们向丹麦IVF登记处的5879对夫妇邮寄了问卷，该登记处涵盖1993年以后的所有IVF治疗（应答率68.2%）。男性金属工人亚组收到了关于焊接暴露情况的第二份问卷（n = 319名男性，应答率77%）。结局信息从国家健康登记处收集。使用Cox回归分析首次hCG阳性妊娠的存活情况。
在父亲暴露于不锈钢焊接和低碳钢焊接的妊娠中，妊娠28周前因自发流产而终止的比例分别为18%（n = 91例妊娠）和25%（n = 128例）。在2925例妊娠的参照组中，流产率为28%。父亲暴露于不锈钢焊接的妊娠的风险比为0.6（95%CI 0.4 - 1.0）。
我们发现，接受IVF治疗且配偶有任何类型焊接暴露史的女性，其自发流产风险并未增加。由于IVF妊娠的受精和选择过程与自然妊娠不同，因此该阴性结果不一定适用于其他妊娠。
