Urinary arsenic and spontaneous pregnancy loss - a hypothesis-generating case-control investigation in western Romania.
Urinary arsenic and spontaneous pregnancy loss - a hypothesis-generating case-control investigation in western Romania.
复制标题
尿砷和自发性妊娠丢失——罗马尼亚西部的一项假设生成病例对照调查。
DOI：
10.1016/j.chemosphere.2023.139167
复制
发表时间：
2023
期刊：
影响因子：
8.8
通讯作者：
Gurzau,EugenS
中科院分区：
文献类型：
--
作者：
Neamtiu,IuliaA;Bloom,MichaelS;Clark,JulianaM;Pop,Cristian;Marincas,Olivian;Berindan-Neagoe,Ioana;Braicu,Cornelia;Gurzau,EugenS
砷是砷流行地区饮用水的天然污染物，对公众健康构成威胁。本研究的目的是评估低-中度饮水砷暴露人群（大多数<10 μg/L）尿砷浓度与自然流产的关系。我们招募了150名自发性流产的妇女和150名与孕龄匹配的正在进行妊娠的对照。我们使用高效液相色谱法与电感耦合等离子体质谱法配对测定尿中的砷。调整混杂因素后的条件Logistic回归模型显示，尿砷与自然流产无关。然而，在相互作用模型中，尿砷（III + V）盐浓度增加10 μg/L与使用产前维生素的妇女自发丢失的几率增加8.00倍（95% CI：0.68，3.35 × 105）相关（相互作用P = 0.07），尽管效应估计不精确。在另一个相互作用模型中，产前使用维生素与较低的丢失几率相关（OR = 0.30; 95% CI：0.13，0.66），尽管在尿无机砷增加10 μg/L的情况下，这种相关性减弱（OR = 0.44; 95% CI：0.70，3.22）。在另一个相互作用模型中，尿可替宁>50 μg/L的女性中，尿总砷与1.48倍（95% CI：0.20，11.35）的丢失几率相关（相互作用P = 0.07）。这些结果表明，在妊娠期间吸烟（尿可替宁>50 μg/L）的女性中，与尿总砷增加相关的妊娠丢失几率可能适度增加。产前维生素的使用可能作为砷暴露相关的妊娠丢失的保护因素，但似乎是随着尿无机砷浓度的增加，保护性较低。
Arsenic occurs as a natural contaminant of drinking water supplies in arsenic endemic areas, posing a threat to public health. Our aim was to evaluate the relationship between urinary arsenic concentrations and spontaneous pregnancy loss in a population with low-moderate level drinking water arsenic exposure (mostly <10 μg/L). We enrolled 150 women with incident spontaneous pregnancy losses and 150 controls with ongoing pregnancies matched by gestational age. We measured arsenic species in urine using high performance liquid chromatography paired to inductively coupled plasma mass spectrometry. Urinary arsenic was not related to spontaneous pregnancy loss in conditional logistic regression models adjusted for confounding factors. However, a 10 μg/L increase in urinary arsenic (III + V) salt concentrations was associated with 8.00-fold (95% CI: 0.68, 3.35 × 105) greater odds of spontaneous loss among women using prenatal vitamins in an interaction model (P for interaction = 0.07), although the effect estimate was imprecise. In an additional interaction model, prenatal vitamin use was associated with lower odds of loss (OR = 0.30; 95% CI: 0.13, 0.66), although the association was diminished in the presence of a 10 μg/L increase in urinary inorganic arsenic (OR = 0.44; 95% CI: 0.70, 3.22). Total urinary arsenic was associated with 1.48-fold (95% CI: 0.20, 11.35) greater odds for loss among women with urinary cotinine >50 μg/L in another interaction model (P for interaction = 0.07). These results suggest a potential modest increase in the odds of pregnancy loss associated with increased total urinary arsenic among women smoking during pregnancy (urinary cotinine >50 μg/L). Prenatal vitamin use may act as a protective factor for arsenic exposure associated pregnancy loss, but appears to be less protective with increasing urinary inorganic arsenic concentrations.