Exposure to toxic metals and per- and polyfluoroalkyl substances and the risk of preeclampsia and preterm birth in the United States: a review.
Exposure to toxic metals and per- and polyfluoroalkyl substances and the risk of preeclampsia and preterm birth in the United States: a review.
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DOI：
10.1016/j.ajogmf.2021.100308
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发表时间：
2021-05
影响因子：
6.3
通讯作者：
Manuck TA
中科院分区：
文献类型：
--
作者：
Stone J;Sutrave P;Gascoigne E;Givens MB;Fry RC;Manuck TA
先兆子痫和早产是最常见的妊娠并发症之一，也是美国孕产妇和胎儿发病率和死亡率的主要原因。不良妊娠结局本质上是多因素的，越来越多的证据表明，早产和先兆子痫背后的病理生理可能是相似的——具体来说，这两种疾病都可能涉及胎盘血管的异常。越来越多的文献支持，暴露于空气、水、土壤、消费者和家庭产品中的环境污染物是影响不良妊娠结局发展的关键因素。在孕妇中，已在尿液、外周血、指甲屑和羊水中检测到有毒金属。胎盘是母亲和胎儿接触各种有毒物质之间的“看门人”，因为它可以减少或增加胎儿接触各种有毒物质的机会。目前提出的毒物介导的损伤机制包括胎盘血管生成中断、促炎状态上调、氧化应激导致前列腺素生成和随后的宫颈成熟、子宫收缩和膜破裂，以及导致内分泌和免疫系统信号调节中断的表观遗传变化。本综述的目的是对美国环境污染物，特别是无机（如镉、砷、铅和汞）和有机（如全氟烷基和多氟烷基物质）毒物与美国妇女先兆子痫和早产之间关系的研究进行概述。
Preeclampsia and preterm birth are among the most common pregnancy complications and are the leading causes of maternal and fetal morbidity and mortality in the United States (U.S.). Adverse pregnancy outcomes are multifactorial in nature and increasing evidence suggests that the pathophysiology behind preterm birth and preeclampsia may be similar – specifically, both of these disorders may involve abnormalities in placental vasculature. A growing body of literature supports that exposure to environmental contaminants in the air, water, soil, consumer and household products serves as a key factor influencing the development of adverse pregnancy outcomes. In pregnant women, toxic metals have been detected in urine, peripheral blood, nail clippings, and amniotic fluid. The placenta serves as a ‘gatekeeper’ between maternal and fetal exposures, as it can reduce or enhance fetal exposure to various toxicants. Proposed mechanisms underlying toxicant-mediated damage include disrupted placental vasculogenesis, an upregulated proinflammatory state, oxidative stressors contributing to prostaglandin production and consequent cervical ripening, uterine contractions, and ruptured membranes, and epigenetic changes that contribute to disrupted regulation of endocrine and immune system signaling. The objective of this review is to provide an overview of studies examining the relationships between environmental contaminants in the U.S. setting, specifically inorganic (e.g., cadmium, arsenic, lead, and mercury) and organic [e.g., per- and polyfluoroalkyl substances (PFAS)] toxicants, and the development of preeclampsia and preterm birth among U.S. women.