Luu Thi Ha, Ma Gege, Jin Ming, Liu Xiaojing, Ren Mengyuan, Gao Suhong, Wang Jiamei, Ye Rongwei, Liu Xiaohong, Li Nan
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Institute of Reproductive and Child Health, Peking University, Beijing 100191, China.
Toxics. 2025 Jul 8;13(7):575. doi: 10.3390/toxics13070575.
Heavy metals (lead [Pb], cadmium [Cd], arsenic [As], mercury [Hg], manganese [Mn], copper [Cu], zinc [Zn], and iron [Fe]) might be risk factors for pre-eclampsia (PE), whereas their joint effect remains unclear. To address this issue, we conducted a nested case-control study consisting of 49 PE cases and 329 controls from a Chinese prospective birth cohort and divided the participants into low/high and quartile groups based on hair metal concentrations. We used logistic regression models and a weighted quantile sum (WQS) model to investigate the independent and mixed associations between these eight heavy metals in maternal hair and the risk of PE. After multivariable adjustment, high hair Pb was associated with a 2.53-fold increased risk of PE, and significantly higher risks of PE were also observed in quartiles 2 to 4 of Pb and quartiles 3 to 4 of Fe. The WQS model revealed a statistically significant association between maternal co-exposure to all eight heavy metals and the risk of PE, with Pb, As, and Fe presenting the biggest risk. Therefore, high maternal exposure to heavy metals may increase the risk of PE. It is crucial to consider co-exposure to multiple heavy metals throughout pregnancy in future research endeavors.
重金属（铅[Pb]、镉[Cd]、砷[As]、汞[Hg]、锰[Mn]、铜[Cu]、锌[Zn]和铁[Fe]）可能是子痫前期（PE）的危险因素，但其联合效应尚不清楚。为解决这一问题，我们进行了一项巢式病例对照研究，该研究纳入了来自中国一个前瞻性出生队列的49例PE病例和329例对照，并根据头发中的金属浓度将参与者分为低/高组和四分位数组。我们使用逻辑回归模型和加权分位数和（WQS）模型来研究母亲头发中这八种重金属与PE风险之间的独立关联和混合关联。经过多变量调整后，头发中铅含量高与PE风险增加2.53倍相关，在铅的第2至4四分位数和铁的第3至4四分位数中也观察到PE风险显著更高。WQS模型显示，母亲同时接触所有八种重金属与PE风险之间存在统计学上的显著关联，其中铅、砷和铁的风险最大。因此，母亲高暴露于重金属可能会增加PE的风险。在未来的研究中，在整个孕期考虑多种重金属的共同暴露至关重要。
