Clin Lab. 2020 May 1;66(5). doi: 10.7754/Clin.Lab.2019.190940.
The aim of the study is to determine the effects of blood lead levels (BLLs) on spontaneous abortion.
A well-matched case-control study was performed at Peking Union Medical College Hospital from 2016 - 2018. Spontaneous abortion cases requiring suction and curettage within 12 weeks gestational age composed the case group. Control group includes pregnancies showing fetal cardiac activity with simultaneous requests for induced abortions matched to case group in age, gravidity, parity, and gestational age.
Three hundred patients with 150 per group were included. Age, gravidity, parity, gestational age and the number of lead exposures, smokers, alcoholic beverage drinkers, and coffee drinkers were not significantly different between the two groups. The mean BLLs were 27.17 μg/L and 17.28 μg/L for the case and control group, respectively (p = 0.000). The odds ratios for spontaneous abortion comparing 5 - 9, 10 - 14, 15 - 24, 25 - 39, and ≥ 40 μg/L with a reference category of < 5 μg/L blood lead were 1.58 (0.23 - 10.90), 3.13 (2.11 - 9.08), 4.63 (1.45 - 14.83), 6.33 (1.95 - 20.56), and 22.56 (4.91 - 103.66), respectively, demonstrating a significant trend (P1 = 0.64, P2 = 0.02, P3 = 0.01, P4 = 0.02, and P5 = 0.00).
Lead contamination and its effect on spontaneous abortion cannot be ignored. During early pregnancy, when BLL is above 10 μg/L, the chance of spontaneous abortion increases compared to BLLs below 5 μg/L. The higher the BLL is, the greater the risk of spontaneous abortion will be.
本研究旨在探讨血铅水平（BLL）对自然流产的影响。
本研究采用病例对照研究，于 2016 年至 2018 年在北京协和医院进行。自然流产组病例为妊娠 12 周内因需要吸宫和刮宫术而就诊的患者。对照组包括妊娠 12 周内有胎儿心管搏动并同时要求药物流产的患者，与病例组在年龄、孕次、产次、孕周上相匹配。
共纳入 300 例患者，每组 150 例。两组患者的年龄、孕次、产次、孕周以及铅暴露次数、吸烟者、饮酒者和咖啡饮用者的数量差异均无统计学意义。病例组和对照组的平均 BLL 分别为 27.17μg/L 和 17.28μg/L（p=0.000）。与 BLL<5μg/L 相比，BLL 为 5-9μg/L、10-14μg/L、15-24μg/L、25-39μg/L 和≥40μg/L 时，自然流产的比值比（OR）分别为 1.58（0.23-10.90）、3.13（2.11-9.08）、4.63（1.45-14.83）、6.33（1.95-20.56）和 22.56（4.91-103.66），差异有统计学意义（P1=0.64，P2=0.02，P3=0.01，P4=0.02，P5=0.00）。
铅污染及其对自然流产的影响不容忽视。在妊娠早期，当 BLL 高于 10μg/L 时，与 BLL 低于 5μg/L 相比，自然流产的几率增加。BLL 越高，自然流产的风险越大。
