夫妇孕前必需微量元素失衡可能会增加自然流产的风险

Couples’ preconception urinary essential trace elements concentration and spontaneous abortion risk:

A nested case-control study in a community population

育龄夫妇孕前尿中必需微量元素浓度与自然流产风险关联的巢氏病例对照研究

Author: Tierong Liao, Feng Ni, Xinliu Yang, Junjun Liu, Luobin Xia, Qianhui Yang, Xin Gao, Chaojie Li, Xuemei Wang, Caiyun Wu, Liuchang Wang, Shuangshuang Bao, Guixia Pan, Chunmei Liang, Hong Jiang, Fangbiao Tao, Shanshan Shao

Source: Ecotoxicology and Environmental Safety

DOI: 10.1016/j.ecoenv.2024.116764

Abstract

Background: Previous studies have indicated a correlation between maternal imbalances in essential trace elements during pregnancy and the occurrence of spontaneous abortion (SA). Nonetheless, the impact of these elements from both partners and during the preconception period remains unexplored.

Objective: This study sought to evaluate the relationship between preconception essential trace elements and spontaneous abortion (SA) based on husband–wife dyads.

Methods: This study selected 390 couples with spontaneous abortion (SA) and 390 matched couples with live births from a preconception cohort of 33,687 couples. Urine samples collected prior to pregnancy were analyzed for ten essential trace elements (Se, Cr, Mo, Cu, Zn, Fe, Mn, V, Co, and Ni) using inductively coupled plasma mass spectrometry (ICP-MS).

Results: Multivariate conditional logistic regression analysis identified that elevated concentrations of Zn (OR = 0.73) and Ni (OR = 0.69) in couples were associated with a reduced risk of SA, whereas elevated levels of Cr (OR = 1.30) and Mn (OR = 1.39) were linked to an increased risk. Restricted cubic spline models suggested a U-shaped association between couples’ Cu and Co concentrations and SA. Bayesian Kernel Machine Regression further supported a U-shaped relationship between the mixture of ten elements and SA, showing significant protection at the 50th and 55th percentiles compared to the 10th percentile. Additionally, the effects of Cr, Zn, Mn, and Ni on SA varied when the concentrations of the other nine elements were held constant at their 25th, 50th, and 75th percentiles. Stratified analysis revealed that maternal Cu (OR = 0.43) and Fe (OR = 0.63) reduced the risk of SA when paternal Cu and Fe were in the lower quartile. Conversely, maternal Cu (OR = 2.03) and Fe (OR = 1.77) increased the risk of SA when paternal concentrations were in the higher quartile. Similar patterns were observed for Cr, Mn, Co, and Zn.

Conclusion: Elevated urinary concentrations of Zn and Ni in couples were associated with a reduced risk of SA, while higher levels of Cr and Mn were linked to an increased risk. Cu, Co, and a mixture of ten essential trace elements exhibited a U-shaped relationship with SA. The impact of certain essential trace elements (Cu, Fe, Cr, Mn, Co, and Zn) on SA in one partner was influenced by their concentrations in the other partner.

Keywords: Spontaneous abortion, essential trace elements, couples, nested case-control study

摘要

背景：已有研究表明妊娠期女性必需微量元素失衡与自然流产相关。然而，伴侣双方和孕前期的必需微量元素浓度对自然流产的影响仍未得到探讨。

目的：基于成对夫妇探讨孕前必需微量元素浓度与自然流产的关系。

方法:本研究从33,687对夫妇的孕前队列中选取了390对自然流产夫妇和390对活产夫妇进行研究。采用电感耦合等离子体质谱（ICP-MS）检测妊娠前收集的尿液样本中10种必需微量元素（Se、Cr、Mo、Cu、Zn、Fe、Mn、V、Co和Ni）浓度。

结果：多因素条件Logistic回归分析发现，夫妻尿中Zn（OR = 0.73）和Ni（OR = 0.69）浓度升高与自然流产风险降低相关，而Cr (OR = 1.30)和Mn (OR = 1.39)浓度升高与自然流产风险增加相关。限制性立方样条模型表明，夫妻的Cu和Co浓度与自然流产呈U型相关。贝叶斯核机回归进一步支持了10种元素与自然流产之间的U型关系，与第10百分位数相比，第50和55百分位数表现出显著的保护作用。此外，当其他9种元素的浓度分别固定在第25、50和75百分位不变时，Cr、Zn、Mn和Ni对自然流产的影响也会发生相应的变化。分层分析显示，当男方的Cu和Fe浓度处于较低的四分位数时，女方的Cu（OR = 0.43）和Fe（OR = 0.63）降低了自然流产的风险。相反，当男方的Cu和Fe浓度较高时，女方的Cu（OR = 2.03）和Fe（OR = 1.77）增加了自然流产的风险。Cr、Mn、Co和Zn也观察到类似的模式。

结论：夫妻尿中Zn和Ni浓度升高与自然流产风险降低有关，而Cr和Mn浓度升高与自然流产风险增加有关。Cu、Co和10种必需微量元素的混合物与自然流产呈U型关系。伴侣一方某些必需微量元素（Cu、Fe、Cr、Mn、Co和Zn）对自然流产的影响受这些元素在另一方体内浓度的影响。