Buck Louis Germaine M, Smarr Melissa M, Sundaram Rajeshwari, Steuerwald Amy J, Sapra Katherine J, Lu Zhaohui, Parsons Patrick J
Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA.
Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA.
Reprod Toxicol. 2017 Apr;69:68-74. doi: 10.1016/j.reprotox.2017.01.011. Epub 2017 Feb 2.
Environmental exposure to metals and metalloids is associated with pregnancy loss in some but not all studies. We assessed arsenic, cadmium, mercury, and lead concentrations in 501 couples upon trying for pregnancy and followed them throughout pregnancy to estimate the risk of incident pregnancy loss. Using Cox proportional hazard models, we estimated hazard ratios (HR) and 95% confidence intervals (CIs) for pregnancy loss after covariate adjustment for each partner modeled individually then we jointly modeled both partners' concentrations. Incidence of pregnancy loss was 28%. In individual partner models, the highest adjusted HRs were observed for female and male blood cadmium (HR=1.08; CI 0.81, 1.44; HR=1.09; 95% CI 0.84, 1.41, respectively). In couple based models, neither partner's blood cadmium concentrations were associated with loss (HR=1.01; 95% CI 0.75, 1.37; HR=0.92; CI 0.68, 1.25, respectively). We observed no evidence of a significant relation between metal(loids) at these environmentally relevant concentrations and pregnancy loss.
在一些但并非所有研究中，环境中金属和类金属暴露与妊娠丢失有关。我们在501对备孕夫妇尝试怀孕时评估了他们体内的砷、镉、汞和铅浓度，并在整个孕期对他们进行跟踪，以估计发生妊娠丢失的风险。使用Cox比例风险模型，我们分别对每个伴侣进行协变量调整后估计妊娠丢失的风险比（HR）和95%置信区间（CI），然后对双方伴侣的浓度进行联合建模。妊娠丢失的发生率为28%。在单个伴侣模型中，女性和男性血镉调整后的最高HR分别为1.08（CI 0.81，1.44）和1.09（95%CI 0.84，1.41）。在基于夫妇的模型中，双方伴侣的血镉浓度均与妊娠丢失无关（HR分别为1.01，95%CI 0.75，1.37；HR为0.92，CI 0.68，1.25）。我们没有发现这些与环境相关浓度的金属（类金属）和妊娠丢失之间存在显著关系的证据。
