Liang Mengdan, Qiu Liping, Lin Biyun, Chen Zhehui, Jiang Xiannuan, Xie Mengying, Xie Xiaowei, Chen Hanbing, He Xiongkun, Huang Xiaoxiao, Lu Liang, Zhang Lanlan, Qiu Hongjie, Chen Yihong, Wu Junqi, Xie Xiaoxu
Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.
The Collaboration Unit for State Key Laboratory of Infectious Disease Prevention and Control, Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China.
Front Public Health. 2025 Jun 16;13:1603156. doi: 10.3389/fpubh.2025.1603156. eCollection 2025.
Exposure to PM has been linked to premature rupture of membranes (PROM). However, research on the effects of PM-bound metals on the PROM is limited.
Here, we investigated this relationship using data from 6090 pregnant women, estimating exposure to 11 PM-bound metals throughout pregnancy. Cox models assessed associations between individual metals and PROM, while grouped weighted quantile sum regression (GWQS), quantile g-computation (Q-gcomp), and Bayesian kernel machine regression (BKMR) were used for metal mixtures.
Exposure to Al, Cd, Pb, Cr, Ni, Se, and Tl increased PROM risk, with hazard ratios ranging from 1.40 to 1.87. As and Mn were also correlated with PROM during specific trimesters. The GWQS model showed a 3% increased risk of PROM with metal mixture exposure (95% CI: 2%, 4%), mainly driven by Pb in the positive direction. The Q-gcomp model revealed a 5% increased risk (95% CI: 2%, 8%), also primarily due to Pb. In the BKMR model, Ni had the highest influence.
Both individual metals and metal mixtures were associated with PROM, with Pb, Se, and Tl positively correlated with preterm PROM.
暴露于细颗粒物（PM）与胎膜早破（PROM）有关。然而，关于与PM结合的金属对PROM影响的研究有限。
在此，我们使用来自6090名孕妇的数据研究了这种关系，估计了整个孕期暴露于11种与PM结合的金属的情况。Cox模型评估了每种金属与PROM之间的关联，而分组加权分位数和回归（GWQS）、分位数g计算（Q-gcomp）和贝叶斯核机器回归（BKMR）用于金属混合物。
暴露于铝、镉、铅、铬、镍、硒和铊会增加PROM风险，风险比范围为1.40至1.87。砷和锰在特定孕期也与PROM相关。GWQS模型显示，暴露于金属混合物会使PROM风险增加3%（95%置信区间：2%，4%），主要由正向的铅驱动。Q-gcomp模型显示风险增加5%（95%置信区间：2%，8%），同样主要归因于铅。在BKMR模型中，镍的影响最大。
单个金属和金属混合物均与PROM有关，铅、硒和铊与早产PROM呈正相关。
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