Ying Wang1, Keke Wang2, Tianbi Han2, Ping Zhang2, Xi Chen3, Weiwei Wu2, Yongliang Feng2, Hailan Yang4, Mei Li2, Bingjie Xie2, Pengge Guo2, Joshua L Warren5, Xiaoming Shi3, Suping Wang6, Yawei Zhang7. 1. Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA. 2. Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China. 3. National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China. 4. Department of Obstetrics, The First Affiliated Hospital, Shanxi Medical University, Taiyuan, China. 5. Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA. 6. Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China. Electronic address: spwang88@163.com. 7. Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Surgery, Yale School of Medicine, New Haven, CT, USA. Electronic address: yawei.zhang@yale.edu.
Abstract
BACKGROUND: Several studies with small sample size have reported inconsistent associations between single metal and preeclampsia (PE). Very few studies have investigated metal mixtures and PE. METHODS: Blood concentrations of chromium (Cr), cadmium, mercury (Hg), arsenic (As), lead (Pb), nickel, cobalt, and antimony were measured using inductively coupled plasma-mass spectrometry among 427 PE women and 427 matched controls from Taiyuan, China. Multivariate logistic regression models, weighted quantile sum (WQS) regression, and principal component analysis were employed to examine exposure to single metals and metal mixtures in relation to PE. RESULTS: An increased prevalence of PE was associated with Cr (OR = 1.76, 95% CI: 1.18, 2.62 and 1.90, 1.22, 2.93 for the middle and high vs. low), Hg (OR = 1.60, 95% CI: 1.08, 2.38 for the high vs. low) and As (OR = 1.64, 95% CI: 1.07, 2.52 for the middle vs. low). The WQS index, predominated by Cr, Hg, Pb, and As, was positively associated with PE. A principal component characterized by Cr and As also exhibited excessive association with PE. The highest PE prevalence was found among women who were overweight/obese before pregnancy and had high Cr levels compared to women who had pre-pregnancy normal body mass index (BMI) and low Cr levels. CONCLUSIONS: Our study provided evidence that exposure to multiple metals was associated with increased prevalence of PE, and the observed association with multiple metals was dominated by Cr, As. Our study also suggested that pre-pregnancy BMI might modify the association between Cr and PE.
BACKGROUND: Several studies with small sample size have reported inconsistent associations between single metal and preeclampsia (PE). Very few studies have investigated metal mixtures and PE. METHODS: Blood concentrations of chromium (Cr), cadmium, mercury (Hg), arsenic (As), lead (Pb), nickel, cobalt, and antimony were measured using inductively coupled plasma-mass spectrometry among 427 PE women and 427 matched controls from Taiyuan, China. Multivariate logistic regression models, weighted quantile sum (WQS) regression, and principal component analysis were employed to examine exposure to single metals and metal mixtures in relation to PE. RESULTS: An increased prevalence of PE was associated with Cr (OR = 1.76, 95% CI: 1.18, 2.62 and 1.90, 1.22, 2.93 for the middle and high vs. low), Hg (OR = 1.60, 95% CI: 1.08, 2.38 for the high vs. low) and As (OR = 1.64, 95% CI: 1.07, 2.52 for the middle vs. low). The WQS index, predominated by Cr, Hg, Pb, and As, was positively associated with PE. A principal component characterized by Cr and As also exhibited excessive association with PE. The highest PE prevalence was found among women who were overweight/obese before pregnancy and had high Cr levels compared to women who had pre-pregnancy normal body mass index (BMI) and low Cr levels. CONCLUSIONS: Our study provided evidence that exposure to multiple metals was associated with increased prevalence of PE, and the observed association with multiple metals was dominated by Cr, As. Our study also suggested that pre-pregnancy BMI might modify the association between Cr and PE.
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