Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Office of Director, and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Environ Res. 2019 Jan;168:375-381. doi: 10.1016/j.envres.2018.09.018. Epub 2018 Sep 18.
Polybrominated diphenyl ethers (PBDEs) have not been studied in relation to incident pregnancy loss in human populations, despite their ubiquitous exposure and purported reproductive toxicity.
To investigate the association between preconception serum PBDE concentrations and incident pregnancy loss.
A preconception cohort of 501 couples was followed while trying to become pregnant, and for whom serum concentrations of 10 PBDE congeners were measured using gas chromatography-high resolution mass spectrometry. Pregnancy was prospectively identified as a positive home pregnancy test on the day of expected menstruation. Incident pregnancy loss was defined for 344 singleton pregnancies as a conversion to a negative home pregnancy test, menses, or clinical diagnosis depending upon gestational age. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for individual and summed PBDEs and incident pregnancy loss, adjusting for relevant covariates and male partners' information. In sensitivity analyses, inverse probability weighting was used to account for couples not becoming pregnant and, thereby, not at risk for loss.
The incidence of prospectively observed pregnancy loss was 28%, and the serum concentrations of PBDE congeners in females were consistently associated with a higher hazard of incident pregnancy loss. Specifically, statistically significant hazard ratios (HRs) for incident pregnancy loss were observed for lower brominated PBDE congeners: 17 (HR 1.23; CI: 1.07-1.42), 28 (HR 1.25; CI: 1.03-1.52), 66 (HR 1.23; CI: 1.07-1.42), and homolog triBDE (HR: 1.25; CI: 1.05-1.49). Findings were robust to various model specifications explored in sensitivity analyses.
Maternal preconception serum concentrations of specific PBDE congeners may increase the hazard of incident pregnancy.
尽管多溴二苯醚（PBDEs）无处不在且具有潜在的生殖毒性，但在人类人群中尚未对其与妊娠丢失的关系进行研究。
研究受孕前血清 PBDE 浓度与妊娠丢失之间的关联。
对 501 对夫妇进行了一项受孕前队列研究，在尝试受孕期间对他们进行了随访，并使用气相色谱-高分辨率质谱法测量了 10 种 PBDE 同系物的血清浓度。受孕是通过预期经期当天的阳性家庭妊娠试验来前瞻性确定的。对于 344 例单胎妊娠，将妊娠丢失定义为阴性家庭妊娠试验、月经或临床诊断的转换，具体取决于妊娠龄。使用 Cox 比例风险模型来估计个体和总和 PBDE 与妊娠丢失的风险比（HRs）和 95％置信区间（CIs），并调整了相关协变量和男性伴侣的信息。在敏感性分析中，采用逆概率加权法来考虑未受孕的夫妇，从而使他们没有妊娠丢失的风险。
前瞻性观察到的妊娠丢失发生率为 28％，女性血清 PBDE 同系物浓度与妊娠丢失的风险增加密切相关。具体来说，观察到低溴化 PBDE 同系物的妊娠丢失发生率具有统计学意义的 HR：17（HR 1.23；CI：1.07-1.42）、28（HR 1.25；CI：1.03-1.52）、66（HR 1.23；CI：1.07-1.42）和同系物 triBDE（HR：1.25；CI：1.05-1.49）。在敏感性分析中探索的各种模型规格中，发现结果都是稳健的。
特定 PBDE 同系物的母体受孕前血清浓度可能会增加妊娠丢失的风险。
