Protective effect of high zinc levels on preterm birth induced by mercury exposure during pregnancy: A birth cohort study in China

Associations of maternal blood mercury with preeclampsia and birth outcomes

BACKGROUND

Mercury (Hg) is a highly toxic substance, and its harmful effects on maternal and infant health have been reported. Yet, the associations of Hg exposure with preeclampsia (PE) and adverse birth outcomes are not well understood.

OBJECTIVE

The aim of this study was to investigate the potential effects of maternal Hg exposure on PE and birth outcomes.

METHODS

We conducted a case-control study with 84 participants in China. Logistic models were used to estimate odds ratios for PE risk and birth outcomes according to maternal blood Hg levels, adjusting for potential confounding factors.

RESULTS

Elevated blood Hg levels were associated with increased risks of mild PE (aOR, 7.03; 95% CI, 1.61, 30.62; P < 0.01) and severe PE (aOR, 47.55; 95% CI, 5.27, 429.05; P < 0.05). We also found that increased blood Hg levels were associated with low birth weight (aOR, 1.12; 95% CI, 1.00, 1.25; P < 0.05) and preterm birth (PTB) (aOR, 1.22; 95% CI, 1.08, 1.38; P < 0.05).

CONCLUSIONS

Our study provided evidence that elevated blood Hg levels were significantly associated with an increased risk of PE. In addition, our findings support that increased blood Hg levels might be associated with low birth weight and PTB.

Associations between hair levels of trace elements and the risk of preterm birth among pregnant Wwomen: A prospective nested case-control study in Beijing Birth Cohort (BBC), China

Trace elements have various physiochemical functions in humans and are associated with the occurrence of preterm birth (PB). However, their mixed effects on PB risk have rarely been studied. We aimed to investigate the associations between hair levels of trace elements and PB risk among pregnant women. A nested case-control study with a prospective cohort was conducted in Beijing City, China. We included 82 women who had a PB [total PB (tPB)] as cases [including 40 with a spontaneous PB (SPB)] and 415 who had a term delivery as controls. Hair levels of the concerned trace elements were measured including endocrine disrupting metal(loid)s [EDMs; lead, mercury (Hg), arsenic, and cadmium] and nutritional trace metal(loid)s [NTMs; zinc (Zn), iron (Fe), copper, and selenium]. Logistic regression analysis was performed to estimate the odds ratios (ORs) for PB. Bayesian kernel machine regression (BKMR) was used to assess the associations between mixed exposure to the trace elements and PB risk. Significantly lower maternal hair concentrations of Zn and Fe were observed in the SPB cases than in the controls, whereas no differences for the other trace elements. Single-element modeling results suggested second-quartile Hg maternal hair concentrations, third-quartile Zn concentrations, and fourth-quartile Fe concentrations were associated with a reduced risk of tPB with adjusted ORs of 0.43 [95% confidence interval (CI): 0.21-0.87], 0.38 (95% CI: 0.18-0.82), and 0.48 (95% CI: 0.24-0.98), respectively, compared to first-quartile values. Similar results were obtained for SPB. According to the BKMR models, hair NTMs were significantly, monotonously, and inversely associated with the risk of SPB, after controlling for covariates and levels of the four EDMs. Fe and Zn contributed the most strongly to the association. We concluded that maternal higher levels of NTMs, especially Fe and Zn, may reduce the risk of PB.

Serum metal levels in a population of Spanish pregnant women

OBJECTIVE

To describe serum levels of calcium, copper, selenium, magnesium, iron and zinc and evaluate their relationship with maternal socio-demographic characteristics and dietary variables in women in the first trimester of pregnancy.

METHOD

Cross-sectional study with 1279 participants from the INMA cohorts.

RESULTS

The concentrations of the elements analyzed were within the normal range. Associations with higher levels of these metals were found for calcium with white meat intake (p=0.026), for copper with excess body weight (p <0.01), low social class (p=0.03) and being multipara (p <0.01), for magnesium with being over 35 years old (p=0.001), high social class (p=0.044), primiparous status (p=0.002) and low daily intake of bread (p=0.009) and legumes (p=0.020); for zinc with university education (p=0.039) and residence in Gipuzkoa (p <0.01), and for selenium with residence in Valencia (p <0.01), university education (p=0.001), vitamin B₆ supplementation (p=0.006), fish intake (> 71g/day) (p=0.014) and having been born in Spain (p=0.001). Further, lower iron levels were associated with being overweight (p=0.021) or obese (p <0.001) and vitamin B₁₂ supplementation (p=0.006).

CONCLUSIONS

Our results suggest that trace elements in the analyzed cohorts are adequate for this stage of pregnancy. The variability in these elements is mainly linked to socio-demographic and anthropometric variables.

Distribution of mercury in serum and blood cells and risk of spontaneous preterm birth: A nested case-control study in China

The relationship between maternal mercury (Hg) intake and the risk of spontaneous preterm birth (SPB) remains unclear. We conducted a nested case-control study from a prospective cohort in Shanxi Province, China, to explore their associations. In total, 126 pregnant women with SPB (cases) and 348 controls with term delivery were included. We measured the Hg concentrations in their serum (Hg^s) and blood cell (Hg^c) fractions and calculated the concentration ratio of Hg in serum to Hg in blood cells (Hg^s/c). We found that only the Hg^s/c in the case group was slightly higher than that in control group. The OR of Hg^s/c associated with SPB risk was 1.57 [95%CI: 0.99-2.46] with adjusting confounders. After stratification by sampling time, the association above was only statistically significant in the first trimester. High Hg^s/c may increase the risk of SPB in the first trimester among women with relatively low Hg exposure.