Individual, Independent, and Joint Associations of Toxic Metals and Manganese on Hypertensive Disorders of Pregnancy: Results from the MIREC Canadian Pregnancy Cohort.

Autor: Borghese MM; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada., Fisher M; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada., Ashley-Martin J; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada., Fraser WD; Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada., Trottier H; Department of Social and Preventive Medicine, Université de Montreal, Montreal, Quebec, Canada., Lanphear B; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada., Johnson M; Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada., Helewa M; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada., Foster W; Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada., Walker M; Department of Obstetrics, Gynecology, University of Ottawa, Ottawa, Ontario, Canada., Arbuckle TE; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada.
Jazyk: angličtina
Zdroj: Environmental health perspectives [Environ Health Perspect] 2023 Apr; Vol. 131 (4), pp. 47014. Date of Electronic Publication: 2023 Apr 20.
DOI: 10.1289/EHP10825
Abstrakt: Background: Toxic metals, such as lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg), may be associated with a higher risk of gestational hypertension and preeclampsia, whereas manganese (Mn) is an essential metal that may be protective.
Objectives: We estimated the individual, independent, and joint associations of Pb, Cd, As, Hg, and Mn on the risk of developing gestational hypertension and preeclampsia in a cohort of Canadian women.
Methods: Metal concentrations were analyzed in first and third trimester maternal blood ( n = 1,560 ). We measured blood pressure after 20 wk gestation to diagnose gestational hypertension, whereas proteinuria and other complications defined preeclampsia. We estimated individual and independent (adjusted for coexposure) relative risks (RRs) for each doubling of metal concentrations and examined interactions between toxic metals and Mn. We used quantile g-computation to estimate the joint effect of trimester-specific exposures.
Results: Each doubling of third trimester Pb ( RR = 1.54 ; 95% CI: 1.06, 2.22) and first trimester blood As ( RR = 1.25 ; 95% CI: 1.01, 1.58) was independently associated with a higher risk of developing preeclampsia. First trimester blood As ( RR = 3.40 ; 95% CI: 1.40, 8.28) and Mn ( RR = 0.63 ; 95% CI: 0.42, 0.94) concentrations were associated with a higher and lower risk, respectively, of developing gestational hypertension. Mn modified the association with As such that the deleterious association with As was stronger at lower concentrations of Mn. First trimester urinary dimethylarsinic acid concentrations were not associated with gestational hypertension ( RR = 1.31 ; 95% CI: 0.60, 2.85) or preeclampsia ( RR = 0.92 ; 95% CI: 0.68, 1.24). We did not observe overall joint effects for blood metals.
Discussion: Our results confirm that even low blood Pb concentrations are a risk factor for preeclampsia. Women with higher blood As concentrations combined with lower Mn in early pregnancy were more likely to develop gestational hypertension. These pregnancy complications impact maternal and neonatal health. Understanding the contribution of toxic metals and Mn is of public health importance. https://doi.org/10.1289/EHP10825.
Databáze: MEDLINE
Externí odkaz: