Department of Obstetrics and Gynecology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China.
Department of Clinical Laboratory, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China.
J Clin Lab Anal. 2019 Oct;33(8):e22974. doi: 10.1002/jcla.22974. Epub 2019 Jul 11.
With the development of industrialization, public exposure to toxic metals could occur everywhere, eventually affecting individuals' reproductive systems and even embryos and leading to early pregnancy loss. The aim of the study was to determine the profile of toxic metal levels in pregnant women in the general population and to identify biomarkers for metal toxicity in embryos.
A case-control study with pregnant women was conducted at Peking Union Medical College Hospital in 2016-2018. Women who experienced spontaneous abortion within 12 weeks of gestation comprised the case group, and women with pregnancies showing fetal cardiac activity who requested an induced abortion almost simultaneously were included in the control group. Blood and urine specimen were tested for concentrations of cadmium, chromium, selenium, arsenic, and mercury.
A total of 195 patients were enrolled, with 95 in the case group and 100 in the control group. Significant differences in gravidity, parity, history of miscarriage, mean blood cadmium levels, and mean urine chromium levels were present between the two groups (P1 = 0.013, P2 = 0.000, P3 = 0.000, P4 = 0.002, P5 = 0.046); the odds ratios in the spontaneous abortion with blood cadmium >0.4 µg/L, urine chromium >2 µg/L, gravity <3, parity <2, and history of miscarriage >1 compared with the induced abortion group were 1.26 (1.09, 1.85), 1.56 (1.23, 2.53), 1.39 (1.17, 1.98), 1.72 (1.21, 4.62), and 1.18 (1.06, 1.65), with P-values of 0.003, 0.031, 0.003, 0.247, and 0.001, respectively.
Blood cadmium and urine chromium levels are two possible biomarkers of toxic metal embryotoxicity in the general population, which means that in the general population, blood cadmium >0.4 µg/L or urine chromium >2 µg/L might indicate an increased risk of spontaneous abortion.
随着工业化的发展，公众可能会在任何地方接触到有毒金属，最终影响个体的生殖系统，甚至胚胎，导致早期妊娠丢失。本研究的目的是确定一般人群中孕妇有毒金属水平的特征，并确定金属毒性的胚胎生物标志物。
2016-2018 年，我们在北京协和医院进行了一项以孕妇为对象的病例对照研究。病例组为妊娠 12 周内自然流产的孕妇，对照组为同时因胎儿心管搏动要求人工流产的孕妇。检测血和尿标本中镉、铬、硒、砷和汞的浓度。
共纳入 195 例患者，其中病例组 95 例，对照组 100 例。两组间的孕次、产次、流产史、血镉均值和尿铬均值差异有统计学意义（P1=0.013，P2=0.000，P3=0.000，P4=0.002，P5=0.046）；与人工流产组相比，血镉>0.4μg/L、尿铬>2μg/L、孕次<3 次、产次<2 次、流产史>1 次的自然流产组发生的比值比分别为 1.26（1.09，1.85）、1.56（1.23，2.53）、1.39（1.17，1.98）、1.72（1.21，4.62）和 1.18（1.06，1.65），P 值分别为 0.003、0.031、0.003、0.247 和 0.001。
血镉和尿铬水平是一般人群中有毒金属胚胎毒性的两个可能的生物标志物，这意味着在一般人群中，血镉>0.4μg/L 或尿铬>2μg/L 可能提示自然流产的风险增加。
