Pan Lele, Zhang Jing, Chen Mingwei, Yuan Li, Chen Rong, Zhao Lina
Department of Obstetrics and Gynecology, Guangdong Women and Children Hospital, No. 13 Guangyuan West Road, Guangzhou, 510000, Guangdong Province, China.
Biol Trace Elem Res. 2024 Dec 9. doi: 10.1007/s12011-024-04479-9.
Micronutrients, namely vitamins and minerals, are associated with pregnancy outcomes. However, the effects reported in previous observational studies and randomized controlled trials have been inconsistent. Using publicly available genetic data, we conducted a two-sample MR analysis to estimate the causal association between 15 micronutrient levels and 12 obstetric-related diseases. Sensitivity analysis was performed to assess the robustness of the results, detect heterogeneity, and examine the potential existence of horizontal pleiotropy. Iron was protective against gestational diabetes mellitus (GDM) (OR = 0.597, 95% CI 0.438-0.814, P = 0.001), while zinc increased the risk of pregnancy hypertension (OR = 1.064, 95% CI 1.004-1.128, P = 0.035). Vitamin B6 was associated with increased risk of spontaneous abortion (OR = 1.222, 95% CI 1.001-1.490, P = 0.047), and vitamin D was linked to poor fetal growth (OR = 1.612, 95% CI 1.018-2.552, P = 0.041). Conversely, vitamin B12 showed protective effects against preterm birth (OR = 0.686, 95% CI 0.482-0.976, P = 0.036). Selenium and vitamin E were protective against polyhydramnios (OR = 0.828, 95% CI 0.698-0.981, P = 0.030; OR = 0.441, 95% CI 0.213-0.910, P = 0.026), whereas selenium increased the risk of premature rupture of membranes (OR = 1.083, 95% CI 1.007-1.164, P = 0.030).However, no causal links were found between the other micronutrients analyzed and obstetric-related diseases. Sensitivity analyses revealed no significant heterogeneity or pleiotropy. Our research has clarified the causal link between micronutrients and obstetric-related diseases, assisting clinicians in offering personalized guidance on the appropriate intake of micronutrients for women preparing for pregnancy and those who are pregnant. These findings are essential for screening and preventing pregnancy complications, and they also provide new insights and evidence for improving pregnancy outcomes through nutritional interventions.
微量营养素，即维生素和矿物质，与妊娠结局相关。然而，先前观察性研究和随机对照试验报告的结果并不一致。我们利用公开可用的基因数据进行了一项两样本孟德尔随机化分析，以估计15种微量营养素水平与12种产科相关疾病之间的因果关联。进行了敏感性分析，以评估结果的稳健性、检测异质性并检查潜在的水平多效性。铁对妊娠期糖尿病（GDM）具有保护作用（OR = 0.597，95%CI 0.438 - 0.814，P = 0.001），而锌会增加妊娠高血压的风险（OR = 1.064，95%CI 1.004 - 1.128，P = 0.035）。维生素B6与自然流产风险增加相关（OR = 1.222，95%CI 1.001 - 1.490，P = 0.047），维生素D与胎儿生长发育不良有关（OR = 1.612，95%CI 1.018 - 2.552，P = 0.041）。相反，维生素B12对早产具有保护作用（OR = 0.686，95%CI 0.482 - 0.976，P = 0.036）。硒和维生素E对羊水过多具有保护作用（OR = 0.828，95%CI 0.698 - 0.981，P = 0.030；OR = 0.441，95%CI 0.213 - 0.910，P = 0.026），而硒会增加胎膜早破的风险（OR = 1.083，95%CI 1.007 - 1.164，P = 0.030）。然而，在所分析的其他微量营养素与产科相关疾病之间未发现因果联系。敏感性分析未显示出显著的异质性或多效性。我们的研究阐明了微量营养素与产科相关疾病之间的因果联系，有助于临床医生为备孕和怀孕女性提供关于适当摄入微量营养素的个性化指导。这些发现对于筛查和预防妊娠并发症至关重要，也为通过营养干预改善妊娠结局提供了新的见解和证据。
