Department of Gynecology and Obstetrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Biol Trace Elem Res. 2018 Dec;186(2):322-329. doi: 10.1007/s12011-018-1312-3. Epub 2018 Apr 12.
Preeclampsia, which is caused by multiple factors, still remains one of the most serious complications of pregnancy. This study was designed to determine cadmium levels in women with preeclampsia compared to those of normotensive women. In this case-control study, maternal blood, umbilical cord blood, and placental cadmium levels were measured by an inductively coupled plasma mass spectrometry system in 51 women presenting consecutively with preeclampsia and 51 normotensive pregnant women. Groups were matched for maternal age, parity, and gestational age. Birth outcomes were recorded, such as gestational age at delivery, birth weight, and Apgar score. Median (interquartile range [IQR]) blood cadmium concentration was 1.21 μg/L (0.76-1.84 μg/L) and 1.09 μg/L (0.72-1.31 μg/L) in women with preeclampsia and normotensive, respectively; values for placental cadmium levels of women with preeclampsia and normotensive were 3.61 μg/kg (2.19-4.37 μg/kg) and 4.28 μg/kg (3.06-5.71 μg/kg), respectively. We observed a statistically significant increase in blood and placental cadmium levels in women with preeclampsia compared to healthy pregnant women. After adjusting for pre-pregnancy body mass index, maternal age, parity, gestational age at sample collection, and maternal calcium and magnesium levels, the odds ratio of having preeclampsia in the high tertile was markedly increased (odds ratio, 7.83 [95% CI, 1.64-37.26]) compared with the low tertile. Interestingly, there was no difference in the cadmium level in umbilical cord blood between the groups. Within the preeclamptic group, higher cadmium status was significantly associated with decreased birth weight. Our study suggested that elevated cadmium level in the maternal circulation could potentially increase the risk of preeclampsia. The results also demonstrate that higher cadmium status may contribute to fetal growth restriction in preeclamptic patients.
子痫前期是由多种因素引起的，仍然是妊娠最严重的并发症之一。本研究旨在比较子痫前期患者与正常血压孕妇的血镉水平。在这项病例对照研究中，通过电感耦合等离子体质谱系统测量了 51 例连续出现子痫前期和 51 例正常血压孕妇的母亲血、脐血和胎盘镉水平。两组按母亲年龄、产次和孕周匹配。记录了出生结局，如分娩时的胎龄、出生体重和阿普加评分。子痫前期患者和正常血压孕妇的血镉浓度中位数（四分位距 [IQR]）分别为 1.21μg/L（0.76-1.84μg/L）和 1.09μg/L（0.72-1.31μg/L）；胎盘镉水平分别为 3.61μg/kg（2.19-4.37μg/kg）和 4.28μg/kg（3.06-5.71μg/kg）。我们观察到子痫前期患者的血镉和胎盘镉水平与健康孕妇相比均显著升高。在校正了孕前体重指数、母亲年龄、产次、样本采集时的孕周以及母亲钙和镁水平后，高三分位的子痫前期发生比值比明显增加（比值比，7.83[95%CI，1.64-37.26]）与低三分位相比。有趣的是，两组脐带血中的镉水平没有差异。在子痫前期组中，较高的镉状态与出生体重降低显著相关。我们的研究表明，母体循环中镉水平升高可能会增加子痫前期的风险。结果还表明，较高的镉状态可能导致子痫前期患者胎儿生长受限。
