State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China.
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
Environ Int. 2020 Nov;144:106061. doi: 10.1016/j.envint.2020.106061. Epub 2020 Sep 2.
Spontaneous abortion is a considerable threat to the physiology and mental health of the mother. The etiology of spontaneous abortion is multifactorial with complicated mechanisms, of which overexposure to non-essential metals (especially heavy metals) has been proposed to be associated with adverse birth outcomes. However, significant knowledge gaps remain to be filled in, such as the deleterious profile of non-essential metals and their interplay with essential metals in abnormal pregnancy. Under this setting, we aimed to address these challenges by conducting a cross-sectional study on 56 patients with spontaneous abortion in the 1 trimester, by comparing to 55 healthy pregnant women in 1 the trimester and 41 non-pregnant healthy women. Overexposure to a few non-essential metals, such as arsenic (As), antimony (Sb) and bismuth (Bi), was found in patients with spontaneous abortion, and likewise, some essential elements, such as magnesium (Mg), copper (Cu), vanadium (V), strontium (Sr) and tin (Sn), were also found to be elevated under spontaneous abortion. Further evidence of abnormal pregnancy was induced by a reduced level of internal hormones necessary for normal gestation, such as estradiol (E2) and progesterone (PRGE) in women with spontaneous abortion. Lactate dehydrogenase (LDH) and thyroid-stimulating hormone (TSH) levels were slightly increased in patients with spontaneous abortion. Comprehensive correlation analyses were carried out to identify the crucial factors that result in abortion. Our data stratified the important variables in decreasing order: PRGE, As, Mg, Sb, Sr, Sn, Bi and pregnant times in the progress of spontaneous abortion. Moreover, labyrinthine associations were uncovered between PRGE, non-essential metals and essential elements in causing spontaneous abortion. Therefore, our combined data unveiled the likely synergistic implications of elevated non-essential metals and the disordered metabolism of essential metals in abnormal pregnancy.
自然流产对母亲的生理和心理健康是一个相当大的威胁。自然流产的病因是多因素的，机制复杂，其中过量接触非必需金属（尤其是重金属）与不良生育结局有关。然而，仍有许多知识空白需要填补，例如非必需金属的有害特征及其与异常妊娠中必需金属的相互作用。在这种情况下，我们旨在通过对 56 例 1 trimester 自然流产患者进行横断面研究来应对这些挑战，将其与 55 例 1 trimester 健康孕妇和 41 例非妊娠健康女性进行比较。发现自然流产患者存在几种非必需金属（如砷（As）、锑（Sb）和铋（Bi））暴露过度，同样，一些必需元素（如镁（Mg）、铜（Cu）、钒（V）、锶（Sr）和锡（Sn））也发现自然流产时升高。进一步的异常妊娠证据是由正常妊娠所需的内部激素水平降低引起的，例如自然流产患者的雌二醇（E2）和孕酮（PRGE）。乳酸脱氢酶（LDH）和促甲状腺激素（TSH）水平在自然流产患者中略有升高。进行了综合相关性分析，以确定导致流产的关键因素。我们的数据按降序排列对重要变量进行了分层：PRGE、As、Mg、Sb、Sr、Sn、Bi 和怀孕次数在自然流产的进展过程中。此外，在导致自然流产方面，还发现了 PRGE、非必需金属和必需元素之间的复杂关联。因此，我们的数据揭示了非必需金属升高和必需金属代谢紊乱在异常妊娠中可能存在协同作用。
