BCNatal. Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Maternal and Child Health Development Network, RETICS. Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain.
BCNatal. Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Maternal and Child Health Development Network, RETICS. Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain.
Placenta. 2021 Jul;110:1-8. doi: 10.1016/j.placenta.2021.05.001. Epub 2021 May 14.
In this study, we aimed at quantifying placental concentrations of 22 chemical elements in small fetuses (SGA) as compared with normally grown fetuses (AGA), and to assess the relationship with Doppler markers of placental function.
Prospective cohort study, including 71 SGA fetuses (estimated fetal weight < 10th percentile) and 96 AGA fetuses (estimated fetal weight > 10th percentile), recruited in the third trimester of gestation. The placental concentration of 22 chemical elements was determined by inductively coupled plasma optical emission spectrophotometer (ICP-OES, ICAP 6500 Duo Thermo): aluminum (Al), beryllium (Be), bismuth (Bi), calcium (Ca), cadmium (Cd), cobalt (Co), chrome (Cr), copper (Cu), magnesium (Mg), manganese (Mn), molybdenum (Mo), nickel (Ni), phosphorus (P), lead (Pb), rubidium (Rb), sulfur (S), strontium (Sr), titanium (Ti), thallium (Tl), antimony (Sb), selenium (Se), and zinc (Zn). Placental function was assessed by measuring the following fetal-maternal parameters: Uterine artery Pulsatility Index (UtA PI), Umbilical artery Pulsatility Index (UA PI) and Middle Cerebral artery Pulsatility Index (MCA PI). The association between the chemical elements concentration and study group and the association with Doppler measures were evaluated.
SGA was associated with significantly (p < 0.05) lower concentrations of Al (AGA 21.14 vs SGA 0.51 mg/kg), Cr (AGA 0.17 vs SGA 0.12 mg/kg), Cu (AGA 0.89 vs SGA 0.81 mg/kg), Mg (AGA 0.007 vs SGA 0.006 g/100g), Mn (AGA 0.60 vs SGA 0.47 mg/kg), Rb (AGA 1.68 vs SGA 1.47 mg/kg), Se (AGA 0.02 vs SGA 0.01 mg/kg), Ti (AGA 0.75 vs SGA 0.05 mg/kg) and Zn (AGA 9.04 vs SGA 8.22 mg/kg). Lower placental concentrations of Al, Cr, Mn, Se, Ti were associated with abnormal UtA, UA and MCA Doppler.
Lower placental concentrations of Al, Cr, Cu, Mn, Rb, Se, Ti and Zn are associated with SGA fetuses and abnormal fetal-maternal Doppler results. Additional studies are required to further understand how chemical elements affect fetal growth and potentially find strategies to prevent SGA.
本研究旨在定量检测小胎儿（SGA）和正常生长胎儿（AGA）胎盘内 22 种化学元素的浓度，并评估其与胎盘功能多普勒标记物的关系。
前瞻性队列研究，纳入了 71 例 SGA 胎儿（估计胎儿体重<第 10 百分位数）和 96 例 AGA 胎儿（估计胎儿体重>第 10 百分位数），均在妊娠晚期入组。通过电感耦合等离子体发射光谱法（ICP-OES，ICAP 6500 Duo Thermo）测定 22 种化学元素的胎盘浓度：铝（Al）、铍（Be）、铋（Bi）、钙（Ca）、镉（Cd）、钴（Co）、铬（Cr）、铜（Cu）、镁（Mg）、锰（Mn）、钼（Mo）、镍（Ni）、磷（P）、铅（Pb）、铷（Rb）、硫（S）、锶（Sr）、钛（Ti）、铊（Tl）、锑（Sb）、硒（Se）和锌（Zn）。通过测量以下胎儿-母体参数评估胎盘功能：子宫动脉搏动指数（UtA PI）、脐动脉搏动指数（UA PI）和大脑中动脉搏动指数（MCA PI）。评估化学元素浓度与研究组之间的相关性，以及与多普勒测量值之间的相关性。
SGA 与 Al（AGA 21.14 比 SGA 0.51 mg/kg）、Cr（AGA 0.17 比 SGA 0.12 mg/kg）、Cu（AGA 0.89 比 SGA 0.81 mg/kg）、Mg（AGA 0.007 比 SGA 0.006 g/100g）、Mn（AGA 0.60 比 SGA 0.47 mg/kg）、Rb（AGA 1.68 比 SGA 1.47 mg/kg）、Se（AGA 0.02 比 SGA 0.01 mg/kg）、Ti（AGA 0.75 比 SGA 0.05 mg/kg）和 Zn（AGA 9.04 比 SGA 8.22 mg/kg）的浓度显著降低（p<0.05）。胎盘内 Al、Cr、Mn、Se、Ti 浓度降低与异常 UtA、UA 和 MCA 多普勒相关。
胎盘内 Al、Cr、Cu、Mn、Rb、Se、Ti 和 Zn 浓度降低与 SGA 胎儿和异常胎儿-母体多普勒结果相关。需要进一步的研究来进一步了解化学元素如何影响胎儿生长，并可能找到预防 SGA 的策略。
