TCM Gynecology Department, Foshan Chancheng Central Hospital, Chancheng District, Foshan, Guangdong province, China.
Candidate of Master's Degree, Foshan Clinical Medical School of Guangzhou University of Chinese Medicine, Chancheng District, Foshan, Guangdong province, China.
Environ Res. 2021 Apr;195:110822. doi: 10.1016/j.envres.2021.110822. Epub 2021 Feb 1.
Preeclampsia is the main cause of maternal and perinatal death, especially in developing countries. Multiple studies suggest that blood lead levels in pregnancy are a risk factor for preeclampsia, even with low levels of blood lead. But less knows the dose-effect relationship of preeclampsia in low blood lead levels.
This study aims to assess the association between blood lead levels and preeclampsia and to explore its dose-effect relationship between low blood lead levels and preeclampsia.
The retrospective cohort study was consecutively conducted in a comprehensive tertiary hospital in Foshan city of Guangdong Province, China, from August 1, 2019, to November 30, 2019. Blood lead levels were measured in maternal whole blood in 12-27 (+6) weeks of pregnancy, using atomic absorption spectrometer. Preeclampsia diagnosis was ascertained from the electronic medical records system. The risk of preeclampsia was estimated by multivariable logical regression analysis, and a two-stage linear regression model was established to find out the dose-effect.
A total of 2174 people were included in this study, and 59 (2.7%) women developed preeclampsia. The dose-effect analysis revealed a non-linear association between blood lead levels and the risk of preeclampsia, with a cut-off point at 4.2 μg/dl. When blood lead levels were over 4.2 μg/dl, the risk of preeclampsia increased significantly with an increase in blood lead levels (OR = 2.05, 95%CI: 1.50, 2.81). In the multivariate regression models, per 1 μg/dl increment in blood lead levels was associated with 43% higher risk of developing preeclampsia (OR = 1.43,95%CI:1.17,1.74). Moreover, the association between blood lead levels and preeclampsia was stable in different subgroups.
Low levels of lead exposure had a dose-effect relationship of preeclampsia, with a cut-off point at 4.2 μg/dl. Blood lead levels had a non-linear association with preeclampsia. When the blood lead levels were higher than 4.2 μg/dl, the risk of preeclampsia increases by 105% for every 1 μg/dl increase in blood lead levels.
子痫前期是孕产妇和围生儿死亡的主要原因，尤其是在发展中国家。多项研究表明，妊娠期间血铅水平是子痫前期的一个危险因素，即使血铅水平较低。但是，对于低水平血铅与子痫前期之间的剂量-效应关系知之甚少。
本研究旨在评估血铅水平与子痫前期之间的关联，并探讨低水平血铅与子痫前期之间的剂量-效应关系。
这是一项在中国广东省佛山市一家综合三级医院进行的回顾性队列研究，研究时间为 2019 年 8 月 1 日至 11 月 30 日。在妊娠 12-27（+6）周时，使用原子吸收光谱仪测量母体全血中的血铅水平。子痫前期的诊断通过电子病历系统确定。采用多变量逻辑回归分析估计子痫前期的风险，并建立两阶段线性回归模型以找出剂量-效应关系。
本研究共纳入 2174 人，其中 59（2.7%）名女性发生子痫前期。剂量-效应分析显示，血铅水平与子痫前期的风险之间呈非线性关联，血铅水平的截断值为 4.2μg/dl。当血铅水平超过 4.2μg/dl 时，随着血铅水平的升高，子痫前期的风险显著增加（OR=2.05，95%CI：1.50，2.81）。在多变量回归模型中，血铅水平每增加 1μg/dl，发生子痫前期的风险增加 43%（OR=1.43，95%CI：1.17，1.74）。此外，血铅水平与子痫前期之间的关联在不同亚组中是稳定的。
低水平的铅暴露与子痫前期存在剂量-效应关系，截断值为 4.2μg/dl。血铅水平与子痫前期之间呈非线性关系。当血铅水平高于 4.2μg/dl 时，血铅水平每增加 1μg/dl，子痫前期的风险增加 105%。
