Yu Chiyang, You Qingxia, Bai Xue, Mu Fangxiang
Department of Reproductive Medicine, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China.
Department of Clinical Laboratory, Southwest Hospital, Army Medical University, Chongqing, 400038, China.
Reprod Biol Endocrinol. 2025 Jun 6;23(1):87. doi: 10.1186/s12958-025-01373-4.
Previous research suggests that heavy metal exposure may lead to pregnancy loss, but findings have varied. This study focuses on examining the relationship between heavy metal exposure (manganese, selenium, cadmium, lead, mercury) and pregnancy loss.
Utilizing data from the 2011-2016 National Health and Nutrition Examination Survey (NHANES), this study included women between 20-80 years with complete pregnancy history, heavy metal exposure data, and covariate information. Pregnancy loss was self-reported by participants. Blood levels of manganese, selenium, cadmium, lead, and mercury were measured using mass spectrometry. Logistic regression, smooth curve fitting, and weighted quantile sum (WQS) regression were employed to investigate the association between heavy metal exposure and pregnancy loss. Subgroup analyses were conducted to verify the heterogeneity of the results.
A total of 3623 eligible women were included, with 1607 reporting pregnancy loss. Blood mercury levels were positively correlated with a higher risk of pregnancy loss (odds ratio 1.06, 95% confidence interval 1.03-1.09, P < 0.001), which remained significant in the two adjusted models. A nonlinear association between mercury levels and pregnancy loss was identified. The heterogeneity in this association was influenced by race, education level, body mass index, and age at menarche. No significant links were detected between pregnancy loss and cadmium, lead, manganese, and selenium. WQS regression highlighted the critical role of mercury in pregnancy loss.
Mercury exposure may contribute to a higher risk of pregnancy loss. Reducing heavy metal pollution and minimizing mercury exposure could potentially help improve pregnancy outcomes.
先前的研究表明，接触重金属可能导致流产，但研究结果各不相同。本研究重点探讨重金属暴露（锰、硒、镉、铅、汞）与流产之间的关系。
利用2011 - 2016年美国国家健康与营养检查调查（NHANES）的数据，本研究纳入了年龄在20 - 80岁之间、有完整妊娠史、重金属暴露数据和协变量信息的女性。流产情况由参与者自行报告。使用质谱法测量血液中锰、硒、镉、铅和汞的水平。采用逻辑回归、平滑曲线拟合和加权分位数和（WQS）回归来研究重金属暴露与流产之间的关联。进行亚组分析以验证结果的异质性。
共纳入3623名符合条件的女性，其中1607人报告有流产经历。血液汞水平与流产风险较高呈正相关（优势比1.06，95%置信区间1.03 - 1.09，P < 0.001），在两个校正模型中仍具有统计学意义。确定了汞水平与流产之间的非线性关联。这种关联的异质性受种族、教育水平、体重指数和初潮年龄的影响。未发现流产与镉、铅、锰和硒之间存在显著关联。WQS回归突出了汞在流产中的关键作用。
汞暴露可能导致更高的流产风险。减少重金属污染并尽量减少汞暴露可能有助于改善妊娠结局。
