Faculty of Health Science, Interdisciplinary School of Health Sciences, Ottawa, Canada.
Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada.
Crit Rev Toxicol. 2019 Jul;49(6):461-478. doi: 10.1080/10408444.2019.1629873. Epub 2019 Sep 11.
Pregnancy is a vulnerable period for the mother and the infant and exposures to environmental chemicals can influence neonatal morbidity and mortality. There is a momentum toward understanding and exploring the current maternal biological mechanisms specific to effects, to improve birth outcomes. This study aims to examine the current understanding of the role of biomarkers that may be associated with term of pregnancy, infant birth weights and infant development . Electronic searches were conducted in PubMed, Embase, OvidMD, and Scopus databases; and all relevant research articles in English were retrieved. Studies were selected if they evaluated maternal blood plasma/serum biomarkers proposed to influence adverse birth outcomes in the neonate. Data were extracted on characteristics, quality, and odds ratios from each study and meta-analysis was conducted. A total of 54 studies (35 for meta-analysis), including 43,702 women, 50 plasma markers and six descriptors of birth outcomes were included in the present study. The random effect point estimates for risk of adverse birth outcomes were 1.61(95%CI: 1.39-1.85, < 0.0001) for inflammation-related biomarkers and 1.65(95%CI: 1.22-2.25, = 0.0013) for growth factor/hormone-related biomarkers. All subgroups of plasma markers showed significant associations with adverse birth outcomes with no apparent study bias. The two subsets of plasma markers identified in this study (inflammation-related and growth factor/hormone-related) may serve as potentially valuable tools in the investigation of maternal molecular mechanisms, especially select pathways underlying inflammatory and immunological mediation in terms of modulating adverse infant outcomes. Future large, prospective cohort studies are needed to validate the promising plasma biomarkers, and to examine other maternal biological matrices such as cervicovaginal fluid and urine.
妊娠是母亲和婴儿的脆弱时期，环境化学物质的暴露会影响新生儿的发病率和死亡率。目前有一股势头是为了了解和探索当前与特定影响相关的母体生物学机制，以改善出生结局。本研究旨在研究可能与妊娠期限、婴儿出生体重和婴儿发育相关的生物标志物的当前理解。在 PubMed、Embase、OvidMD 和 Scopus 数据库中进行了电子检索，并检索了所有相关的英文研究文章。如果研究评估了母体血浆/血清生物标志物对新生儿不良出生结局的影响，则选择这些研究。从每项研究中提取特征、质量和优势比的数据，并进行荟萃分析。本研究共纳入 54 项研究（35 项进行荟萃分析），包括 43702 名女性、50 个血浆标志物和 6 个出生结局描述符。炎症相关生物标志物的不良出生结局风险的随机效应点估计值为 1.61（95%CI：1.39-1.85， < 0.0001），生长因子/激素相关生物标志物为 1.65（95%CI：1.22-2.25， = 0.0013）。所有血浆标志物亚组均与不良出生结局显著相关，且无明显研究偏倚。本研究确定的两种血浆标志物亚组（炎症相关和生长因子/激素相关）可能作为研究母体分子机制的潜在有价值的工具，特别是在调节炎症和免疫介导的选择途径方面，以改善不良婴儿结局。需要进行大型前瞻性队列研究来验证有前途的血浆生物标志物，并研究其他母体生物基质，如宫颈阴道液和尿液。
