Association of maternal serum copper during early pregnancy with the risk of spontaneous preterm birth: A nested case-control study in China
Association of maternal serum copper during early pregnancy with the risk of spontaneous preterm birth: A nested case-control study in China
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妊娠早期母体血清铜与自发性早产风险的关系：中国巢式病例对照研究
DOI：
10.1016/j.envint.2018.11.009
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发表时间：
2019-01-01
影响因子：
11.8
通讯作者：
Ren, Aiguo
中科院分区：
文献类型：
--
作者：
Hao, Yongxiu;Pang, Yiming;Ren, Aiguo
背景：母体铜水平对自然早产风险的影响仍存在争议。因此，我们在山西省开展了一项前瞻性嵌套病例对照研究，以探讨母血铜水平与SPB风险的关系，以及脂代谢的潜在中介作用。方法：从4229名妇女中，147名孕20-36周的妇女(病例)和381名孕37周分娩的妇女(对照组)进入嵌套病例对照研究。于孕4~22周采集母血，测定血清铜、总胆固醇(TC)、甘油三酯(TG)浓度。通过问卷调查收集了有关产妇社会人口特征的信息。使用非条件Logistic回归模型估计铜、总胆固醇或甘油三酯水平与SPB风险的关系。结果：病例组血清铜浓度(中位数：184mU/dL)显著高于对照组(中位数：166mU/dL，p<；0.0001)。在调整取样时间、母亲年龄、孕前体重指数、教育程度、职业、产次、自然流产史、叶酸使用、用药情况、孕前被动吸烟状况、儿童性别和禁食状况后，第二、三、四分位数中与SPB相关的优势比分别增加到2.02(95%可信区间：1.07，3.82)、3.10(1.54，6.22)和4.18(2.11，8.27)。血浆TC和TG浓度与SPB风险呈正相关，且呈剂量依赖关系。然而，当按抽样时间分层时，上述关系在前三个月显著，而在后三个月不显著。此外，血浆TC和TG浓度与血清铜浓度呈正相关。结论：妊娠早期母体铜水平过高可能通过增加血浆TC和TG浓度而增加SPB的危险性。
Background: The effect of maternal copper (Cu) level on the risk of spontaneous preterm birth (SPB) remains debate. Therefore, we conducted a prospective nested case-control study in Shanxi Province to investigate the relationship between maternal serum Cu concentration and SPB risk, as well as the potential mediation effect of lipid metabolism.Method: From an overall cohort of 4229 women, 147 women affected by SPB at 20-36 gestational weeks (cases) and 381 women who delivered at >= 37 gestational weeks (controls) were included in our nested case-control study. Maternal blood samples were collected during 4-22 gestational weeks, and the concentrations of Cu, total cholesterol (TC), and triglycerides (TG) were measured. Information on maternal social demographic characteristics were collected using questionnaires. Unconditional logistic regression models were used to estimate the associations of Cu, TC or TG levels with SPB risk. Linear regressions were used to assess the relationships between concentrations of Cu and TC or TG.Results: Serum Cu concentrations in the case group (median: 184 mu g/dL) were significantly higher than those in the control group (median: 166 mu g/dL, p < 0.0001). Compared to the lowest serum Cu levels, the odds ratios associated with SPB increased to 2.02 (95% confidence interval [CI]: 1.07, 3.82), 3.10 (1.54, 6.22) and 4.18 (2.11, 8.27) in the second, third and fourth quartile respectively, after adjusting for sampling time, maternal age, pre-pregnancy BMI, education, occupation, parity, spontaneous abortion history, folic acid use, medication use, pre-pregnancy passive smoking status, child gender and fasting status. Plasma concentrations of TC and TG were positively associated with SPB risk in a dose-dependent manner. However, when stratified by sampling time, the above-mentioned relationships were significant in the first trimester but not in the second. In addition, plasma concentrations of TC and TG were positively correlated with serum Cu concentrations.Conclusions: High maternal Cu level in the first trimester may increase the risk of SPB, by potentially increasing plasma concentrations of TC and TG.