Agostinho de Sousa João, Griffiths Alexander, Dalrymple Kathryn V, White Sara L, von Meyenn Ferdinand, Poston Lucilla, Rigutto-Farebrother Jessica, Flynn Angela C
Laboratory of Nutrition and Metabolic Epigenetics, Department of Health Sciences and Technology, ETH Zurich, Zürich 8092, Switzerland.
PSI Center for Scientific Computing, Theory and Data, Paul Scherrer Institute, Villigen 5232, Switzerland.
Metallomics. 2025 Aug 5;17(8). doi: 10.1093/mtomcs/mfaf031.
Characterization of serum metal element concentrations in pregnancy enables the elucidation of relationships with maternal-fetal and neonatal health. Metal elements in the blood serve as essential cofactors for enzymatic reactions and contribute to blood gas homeostasis, hormone synthesis, and physiological immune function for mother and fetus. Sub-optimal concentrations of some metals have been linked to adverse outcomes, including preterm birth, low birth weight, and impaired neurodevelopment. Maternal obesity also adversely influences metabolic status, including metal metabolism, with the potential for a heightened risk of complications at delivery and long-term health issues in offspring. Research on metal element levels in pregnant women with obesity and their effects on pregnancy outcomes is however limited. This study aims to characterize mid-gestation serum concentrations of 18 metal elements in samples from 755 pregnant women with obesity enrolled in the UK Pregnancies Better Eating and Activity Trial (UPBEAT) and identify associations with pregnancy outcomes. We found that calcium concentration tended to decrease with increasing parity, with an estimated reduction of 6.03 mg/L in multiparous participants compared to nulliparous participants (95% CI: -9.50 to -2.57 mg/L, P = 0.001). Additionally, elevated manganese concentrations at mid-pregnancy were associated with an increased incidence of antepartum haemorrhage after 34 weeks (OR: 4.62, 95% CI: 2.06-12.4, P < 0.001), and higher maternal phosphorus levels were linked to neonatal intensive care unit admissions (OR: 2.83, 95% CI: 1.75-4.67, P < 0.001). A future focus on dysregulation of these metal elements is needed to improve understanding of the clinical associations observed.
孕期血清金属元素浓度的特征分析有助于阐明其与母婴及新生儿健康的关系。血液中的金属元素是酶促反应的必需辅助因子，有助于维持母婴的血气稳态、激素合成及生理免疫功能。某些金属元素浓度未达最佳水平与不良结局相关，包括早产、低出生体重和神经发育受损。母体肥胖也会对代谢状态产生不利影响，包括金属代谢，可能增加分娩时并发症的风险以及后代的长期健康问题。然而，关于肥胖孕妇体内金属元素水平及其对妊娠结局影响的研究有限。本研究旨在分析参与英国孕期更好饮食与活动试验（UPBEAT）的755名肥胖孕妇样本中18种金属元素在妊娠中期的血清浓度特征，并确定其与妊娠结局的关联。我们发现，随着产次增加，钙浓度呈下降趋势，经产妇参与者的钙浓度估计比初产妇参与者降低6.03mg/L（95%CI：-9.50至-2.57mg/L，P=0.001）。此外，妊娠中期锰浓度升高与34周后产前出血发生率增加相关（OR：4.62，95%CI：2.06-12.4，P<0.001），而母体磷水平较高与新生儿重症监护病房入院相关（OR：2.83，95%CI：1.75-4.67，P<0.001）。未来需要关注这些金属元素的失调情况，以增进对所观察到的临床关联的理解。
