Department of Human Genetics, Punjabi University, Patiala, India.
Laboratory for Reproductive and Developmental Disorders, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, India.
Gynecol Endocrinol. 2022 Jan;38(1):16-21. doi: 10.1080/09513590.2021.1942450. Epub 2021 Jun 25.
Spontaneous abortions are the most severe complication of early pregnancy and are a major reproductive health problem. Although this could be caused due to various cytogenetic, immunological, or endocrinological reasons, role of environmental toxicants cannot be ruled out. In order to explore the role of cadmium and lead in causing spontaneous abortions, current systematic review and meta-analysis had been carried out.
Literature search was performed using appropriate keywords in PubMed, Science Direct, Cochrane Library, and Google Scholar databases up to December 25 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Metananalysis was carried out with the help of RevMan software (version 5.3).
Meta-analysis of nine studies on cadmium concentrations in blood of women with at least one spontaneous abortions and controls revealed standardized mean difference (SMD)=3.39, 95% CI (2.17, 4.61), with < .05. Similarly, meta-analysis of eight studies on lead concentrations revealed standardized mean difference (SMD)=6.24, 95% CI (4.34, 8.14), with < .05.
Populations exposed to heavy metals such as cadmium and lead are at higher risk of pregnancy loss. Therefore, couples experiencing repeated pregnancy losses may be screened for heavy metal load.
自然流产是早孕最严重的并发症，也是主要的生殖健康问题。尽管这可能是由于各种细胞遗传学、免疫学或内分泌学原因引起的，但不能排除环境毒物的作用。为了探讨镉和铅在导致自然流产中的作用，进行了当前的系统评价和荟萃分析。
根据系统评价和荟萃分析的首选报告项目（PRISMA）准则，在 PubMed、Science Direct、Cochrane 图书馆和 Google Scholar 数据库中使用适当的关键字进行文献检索，截至 2020 年 12 月 25 日。使用 RevMan 软件（版本 5.3）进行荟萃分析。
对至少有一次自然流产和对照组的女性血液中镉浓度进行的 9 项研究的荟萃分析显示，标准化均数差（SMD）=3.39，95%置信区间（2.17，4.61），<0.05。同样，对 8 项关于铅浓度的研究进行的荟萃分析显示，标准化均数差（SMD）=6.24，95%置信区间（4.34，8.14），<0.05。
接触重金属（如镉和铅）的人群流产风险较高。因此，反复发生妊娠丢失的夫妇可能需要筛查重金属负荷。
