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Tousizadeh S, Mohammadi-Moghadam F, Mohammadian-Hafshejani A, Sadeghi R. Comparison of zinc levels in mothers with and without abortion: A systematic review and meta-analysiss. Heliyon 2024; 10:e30605. [PMID: 38774104 PMCID: PMC11106818 DOI: 10.1016/j.heliyon.2024.e30605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction Zinc is an essential trace element involved in different physiological functions. During pregnancy, it plays a crucial role in healthy embryogenesis. Abortion is the most severe problem associated with early pregnancy complications. This study aims to compare the levels of Zn in mothers with and without abortion. Methods This study is a systematic review and meta-analysis of studies published between 1980 and 2022 in PubMed, Science Direct, Pro Quest, Wiley, Web of Science, and Scopus databases. The search was conducted using both main and Mesh keywords, specifically targeting terms related to abortion, pregnancy loss, and zinc. Heterogeneity in the studies included in the meta-analysis was evaluated using statistical tests such as the chi-square test, I2, and forest plots. Publication bias was assessed using Begg's and Egger's tests. All analyses were conducted using Stata 15, and statistical significance was considered at p < 0.05. Results In general, nine studies were included in this analysis. Based on the results of the meta-analysis, the mean difference in the Zn level between mothers with and without abortion is equal to 193.18 (95 % CI; 107.11 to 279.25, P ≤ 0.001). In other words, the level of Zn in the group of mothers without abortion is 193 units higher than the group of mothers with abortion. The investigation into the comparison of Zn levels in mothers with and without abortion did not reveal any indication of publication bias according to both Begg's test (P-value = 0.858) and Egger's test (P-value = 0.270). Conclusion the study findings indicate a significant association between lower levels of Zn in mothers with abortion compared to mothers without abortion. This suggests that a higher level of Zn may have a preventive effect on the occurrence of abortion in pregnant women. The data also highlights the positive role of trace metals, particularly Zn, in influencing pregnancy outcomes and suggests that maintaining adequate levels of Zn may reduce the likelihood of abortion occurrence, along with other contributing factors. It is important to note that further research, including prospective cohort and experimental studies, is needed to provide more substantial evidence and strengthen these findings.
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Affiliation(s)
- Sepideh Tousizadeh
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fazel Mohammadi-Moghadam
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Ramezan Sadeghi
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Liu Y, Wang T, Ge Y, Shen H, Li J, Qiao C. Individual and combined association between nutritional trace metals and the risk of preterm birth in a recurrent pregnancy loss cohort. Front Nutr 2023; 10:1205748. [PMID: 38099181 PMCID: PMC10720726 DOI: 10.3389/fnut.2023.1205748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
Background Recurrent pregnancy loss (RPL) was associated with an elevated risk of pregnancy complications, particularly preterm birth (PTB). However, the risk factors associated with PTB in RPL remained unclear. Emerging evidence indicated that maternal exposure to metals played a crucial role in the development of PTB. The objective of our study was to investigate the individual and combined associations of nutritional trace metals (NTMs) during pregnancy with PTB in RPL. Methods Using data from a recurrent pregnancy loss cohort (n = 459), propensity score matching (1:3) was performed to control for covariates. Multiple logistic regression and multiple linear regression were employed to identify the individual effects, while elastic-net regularization (ENET) and Bayesian kernel machine regression (BKMR) were used to examine the combined effects on PTB in RPL. Results The logistic regression model found that maternal exposure to copper (Cu) (quantile 4 [Q4] vs. quantile 1 [Q1], odds ratio [OR]: 0.21, 95% confidence interval [CI]: 0.05, 0.74) and zinc (Zn) (Q4 vs. Q1, OR: 0.19, 95%CI: 0.04, 0.77) was inversely associated with total PTB risk. We further constructed environmental risk scores (ERSs) using principal components and interaction terms derived from the ENET model to predict PTB accurately (p < 0.001). In the BKMR model, we confirmed that Cu was the most significant component (PIP = 0.85). When other metals were fixed at the 25th and 50th percentiles, Cu was inversely associated with PTB. In addition, we demonstrated the non-linear relationships of Zn with PTB and the potential interaction between Cu and other metals, including Zn, Ca, and Fe. Conclusion In conclusion, our study highlighted the significance of maternal exposure to NTMs in RPL and its association with PTB risk. Cu and Zn were inversely associated with PTB risk, with Cu identified as a crucial factor. Potential interactions between Cu and other metals (Zn, Ca, and Fe) further contributed to the understanding of PTB etiology in RPL. These findings suggest opportunities for personalized care and preventive interventions to optimize maternal and infant health outcomes.
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Affiliation(s)
- Yilin Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Tingting Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Yunpeng Ge
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Hongfei Shen
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Jiapo Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Chong Qiao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
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