Mwapasa Mphatso, Xu Shanshan, Chakhame Bertha Magreta, Maluwa Alfred, Röllin Halina, Choko Augustine, Huber Sandra, Odland Jon Øyvind
Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
PLOS Glob Public Health. 2024 Nov 14;4(11):e0003521. doi: 10.1371/journal.pgph.0003521. eCollection 2024.
Potentially toxic metals and trace elements have been used in Malawi for a long time. However, data on exposure to these elements by susceptible groups like pregnant women and its associations with reproductive health outcomes in Malawi and southern hemisphere is limited. We investigated the concentrations of potentially toxic metals as well as trace elements in pregnant women and assessed the relationship between the levels these elements in maternal blood and sociodemographic factors, dietary habits and birth outcomes. Maternal data was collected from 605 pregnant women. Provider administered questionnaire was used to collect data on maternal sociodemographic factors, life style and immediate birth outcomes. Maternal venous blood samples were collected from 506 pregnant women in southern Malawi between August 2020 and July 2021. An inductively coupled plasma mass spectrometry (ICP-MS) technique was used to analyse maternal blood samples for concentrations of arsenic (As), copper (Cu), lead (Pb), mercury (Hg), nickel (Ni), selenium (Se) and zinc (Zn). Maternal age emerged as the primary predictor for Cu (p = 0.023), As (p = 0.034) and Hg (p = 0.013) blood concentrations, followed by area of residence, which had significant impact on Ni (p = 0.024) and As (p < 0.001) concentrations. High maternal blood concentrations of Ni were associated with increased birth weight (p = 0.047), birth length (p = 0.026), head circumference (p = 0.029) and gestational age (p = 0.035). Negative associations were observed between maternal whole blood total arsenic (combining organic and inorganic As) concentration and neonatal birth length (p = 0.048) and head circumferences (p < 0.001). Similarly, higher maternal blood Pb concentrations were associated with smaller head circumference (p = 0.002) and birth weight (p = 0.016). This study demonstrates the need to introduce biomonitoring studies in Malawi and countries with similar settings in the global south.
长期以来，马拉维一直在使用潜在有毒金属和微量元素。然而，关于孕妇等易感人群接触这些元素的情况及其与马拉维和南半球生殖健康结果之间的关联的数据有限。我们调查了孕妇体内潜在有毒金属以及微量元素的浓度，并评估了这些元素在母体血液中的水平与社会人口学因素、饮食习惯和出生结局之间的关系。收集了605名孕妇的母体数据。通过提供者发放问卷来收集关于母体社会人口学因素、生活方式和即时出生结局的数据。2020年8月至2021年7月期间，从马拉维南部的506名孕妇中采集了母体静脉血样。采用电感耦合等离子体质谱（ICP-MS）技术分析母体血样中砷（As）、铜（Cu）、铅（Pb）、汞（Hg）、镍（Ni）、硒（Se）和锌（Zn）的浓度。母体年龄是铜（p = 0.023）、砷（p = 0.034）和汞（p = 0.013）血液浓度的主要预测因素，其次是居住地区，其对镍（p = 0.024）和砷（p < 0.001）浓度有显著影响。母体血液中高浓度的镍与出生体重增加（p = 0.047）、出生身长（p = 0.026）、头围（p = 0.029）和孕周（p = 0.035）相关。母体全血总砷（有机砷和无机砷之和）浓度与新生儿出生身长（p = 0.048）和头围（p < 0.001）之间存在负相关。同样，母体血液中较高的铅浓度与较小的头围（p = 0.002）和出生体重（p = 0.016）相关。这项研究表明，有必要在马拉维和全球南方具有类似情况的国家开展生物监测研究。
