E-ISSN: 2619-9467

Contents    Cover    Publication Date: 28 Mar 2019
Year 2019 - Volume 29 - Issue 1

Open Access

Peer Reviewed

ORIGINAL RESEARCH
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The Effect of Heavy Metals on Miscarriage

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J Clin Obstet Gynecol. 2019;29(1):31-8
DOI: 10.5336/jcog.2018-64175
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: In a world where industrial pollution is increasing day by day, heavy metals are one of the important factors threatening human health. The rates of pregnancy loss and subfertility are continuously increasing. This study aims to explain the effects of lead (Pb), cadmium (Cd), and mercury (Hg) levels on the etiology of abortions. Material and Methods: The study was designed as a case-control study with two groups: healthy volunteers (n=20) and miscarriage (n=29) group. The pregnant women with similar demographic characteristics were divided into two groups and peripheral venous blood samples of the study subjects were collected. Atomic absorption spectrophotometer was used to examine the blood samples and the levels of heavy metal. Results: While the Pb level was found to be higher in the miscarriage group (p=0.038), there was no statistical difference between Cd and Hg levels (p>0.005) in the two groups. On comparing the laboratory values of pregnant women in the control and miscarriage groups, blood progesterone values were observed to be lower in the miscarriage group (p<0.001). Conclusion: This study indicates that heavy metals, even below the toxic dose limits, can cause miscarriage. Higher blood Pb levels were found in the miscarriage group while Hg and Cd levels were not different between the two groups. This research points out that the high levels of lead may have an effect on pregnancy loss.
REFERENCES:
  1. Man M, Naidu R, Wong MH. Persistent toxic substances released from uncontrolled e- waste recycling and actions for the future. Sci Total Environ. 2013;463-464:1133-7. [Cross - ref]  [PubMed]
  2. WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstet Gynecol Scand. 1977;56(3):247-53. [PubMed]
  3. National Institute for Health and Clinical Excellence. Ectopic pregnancy and miscar- riage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. NICE Clinical Guideline 154. Manchester (UK): NICE; 2012. (date of ac- cess: 25.01.2019). [Link]
  4. Jelliffe-Pawlowski LL, Miles SQ,  Courtney JG, Materna B, Charlton V. Effect of magni- tude and timing of maternal pregnancy blood  lead (Pb) levels on birth outcomes. J Peri- natol.  2006:26(3):154-62. [Crossref]  [PubMed]
  5. Alijotas-Reig J, Garrido-Gimenez C. Current concepts and new trends in the diagnosis and management of recurrent miscarriage. Obstet Gynecol Surv. 2013;68(6):445-66. [Crossref]   [PubMed]
  6. Practice Committee of the American Society for Reproductive Medicine. Evaluation and treatment of recurrent pregnancy loss: a com- mittee opinion. Fertil Steril. 2012;98(5):1103- 11. [Crossref]  [PubMed]
  7. Flora SJS, Pachauri V, Saxena G. Arsenic, cadmium and lead. In: Gupta RC, ed. Reproductive and Developmental Toxicology. 1st ed. London: Elsevier; 2011. p.415-39. [Crossref]
  8. Carmichael NG,  Backhouse BL, Winder  C, Lewis PD. Teratogenicity,  toxicity and perina- tal effects of  cadmium. Hum Toxicol. 1982;1(2):159-86. [Crossref]  [PubMed]
  9. Wang X, Chen C, Wang L, Chen D, Guang W, French J. Conception, early pregnancy loss, and time to clinical pregnancy: a population- based prospective study. Fertil Steril. 2003;79(3):577-84. [Crossref]
  10. Yıldırım E, Derici MK, Demir E, Apaydın H, Koçak Ö, Kan Ö, et al. Is the concentration of cadmium, lead, mercury, and selenium related to preterm birth? Biol Trace Elem Res. 2019;1- 7. [Crossref]
  11. Foster WG,  Neal MS, Han  MS, Dominguez MM. Environmental  contaminants and human infertility: hypothesis or  cause for concern?  J Toxicol Environ Health B Crit Rev. 2008;11(3- 4):162-76. [Crossref]  [PubMed]
  12. Wang F,  Fan F, Wang  L, Ye W,  Zhang Q, Xie S.  Maternal cadmium levels  during preg- nancy and  the relationship with  preeclampsia and fetal biometric  parameters. Biol Trace Elem Res. 2018;186(2):322-9.  [Crossref]  [PubMed]
  13. Blindauer CA, Leszczyszyn OI. Metalloth- ioneins: unparalleled diversity in structures and functions for metal ion homeostasis and more. Nat Prod Rep. 2010;27(5):720-41.  [Crossref]  [PubMed]
  14. Artells E, Palacios Ò, Capdevila M, Atrian S. Mammalian MT1 and MT2 metallothioneins differ in their metal binding abilities. Metal- lomics. 2013;5(10):1397-410. [Crossref]   [PubMed]
  15. Gidlow DA. Lead toxicity. Occup Med (Lond). 2004;54(2):76-81. [Crossref]
  16. Semczuk M, Semczuk-Sikora A. New data on toxic metal intoxication (Cd, Pb, and Hg in particular) and Mg status during preg- nancy. Med Sci Monit. 2001;7(2):332-40.  [PubMed]
  17. Fahim MS, Fahim Z, Hall DG. Effects of subtoxic lead levels on pregnant women in the state of Missouri. Res Commun Chern Pathol Pharmacol. 1976;13(2):309-31.  [PubMed]
  18. Taylor CM,  Tilling K, Golding  J, Emond AM. Low level lead  exposure and pregnancy  out- comes in  an observational birth  cohort study: dose-response relationships.  BMC Res Notes. 2016;9:291. [Crossref]  [PubMed]  [PMC]
  19. Nordberg GF,  Fowler BA, Nordberg  M, Friberg LT. Handbook  on the Toxicology  of Metals. 3 rd ed. London: Elsevier; 2007. p.975.
  20. United States Environmental Protection Agency (US EPA). Economic Analysis of In- cluding Mercury Containing Devices in the Universal Waste System, Notice of Proposed Rulemaking. Washington: Office of Solid Waste and Emergency Response; 2002.
  21. Wild JR,  Metters J. Dental  amalgam. London: Department of  Health Child Dental  Officer; 1998.
  22. Klaassen C. Casarett and Doull's Toxicology - The Basic Science of Poisons. In: Tokar EJ, Boyd WA, Freedman JH, Waalkes MP, eds. Toxic effects of Metals. 8th ed. New York: Mc- Graw Hill Education; 2013. p.997-8.
  23. Yorifuji T, Tsuda T, Takao S, Harada M. Long- term exposure to methylmercury and neuro- logic signs in Minamata and neighboring communities. Epidemiology. 2008;19(1)3-9.  [Crossref] [PubMed]
  24. Karaer A, Tuncay G, Tanrikut E,  Ozgul  O. Blood cadmium concentrations in women with ectopic pregnancy. Biol Trace Element Res. 2018;184(1):42-6. [Crossref]  [PubMed]
  25. Kebbekulus BB. Preparation of samples for metals analysis. Vol 162. In: Mitra S, ed. Sam- ple Preparation Techniques in Analytical Chemistry. Canada: Wiley Interscience; 2003. p.227-70. [Crossref]
  26. Takeda SHK,  Kuno R, Barbosa  F Jr, Gouveia  N. Trace element levels in blood and associ- ated factors in adults living in the metropoli- tan area of São Paulo, Brazil. J Trace Elem Med Biol 2017;44:307-14. [Crossref]  [PubMed]
  27. World Health Organization (WHO). Health Risks of Heavy Metals from Long-Range Transboundary Air-Pollution. Copenhagen: WHO Regional Office for Europe; 2007. p.129. (date of access: 25.01.2019) [Link]
  28. Centers for Disease Control and Prevention. Ettinger  AS, Wengrovitz AG,  Portier C, Brown MJ. Guidelines for the identification and management of lead exposure in preg- nant and lactating women. Atlanta, GA: US Department of Health and Human Services; 2010. p.267. (date of access: 25.01.2019).  [Link]
  29. Committee Opinion.  Lead screening during pregnancy and lactation.  Committee Opinion Number: 533.  American College of  Obstetri- cians and Gynecologists;  2012. p.5. (date  of access: 25.01.2019). [Link]
  30. Omeljaniuk WJ,  Socha K, Soroczynska J, Charkiewicz AE,  Laudanski T, Kulikowski M, et al.  Cadmium and lead  in women who miscarried. Clin Lab.  2018;64(1):59-67. [Crossref]
  31. Hu H, Téllez-Rojo MM, Bellinger D, Smith D, Ettinger AS, Lamadrid-Figueroa H, et al. Fetal lead exposure at each stage of pregnancy as a predictor of infant mental development. En- viron Health Perspect. 2006;114(11):1730-5. [Crossref]  [PubMed]  [PMC]
  32. Durska G. [Levels of lead and cadmium in pregnant women and newborns and evalua- tion of their impact on child development]. Ann Acad Med Stetin.   2001;47:49-60. [PubMed]
  33. Bloom  MS, Fujimoto  VY,  Steuerwald AJ, Cheng  G, Browne RW,  Parsons PJ. Background exposure to toxic metals in women  adversely   influences  pregnancy during in vitro fertilization (IVF). Reprod Tox- icol. 2012;34(3): 471-81.  [Crossref] [PubMed]
  34. Lederman SA, Jones RL,  Caldwell KL, Rauh V, Sheets SE, Tang  D, et al. Relation  between cord blood mercury levels  and early child de- velopment in a World  Trade Center cohort. Environ Health  Persp. 2008;116(8):1085-91. [Crossref]  [PubMed]  [PMC]
  35. Unuvar E, Ahmadov H,  Kiziler AR, Aydemir B,  Toprak S, Ulker V,  et al. Mercury levels  in cord blood and meconium of healthy newborns and venous blood of their mothers: clinical, prospective cohort study. Sci Total Environ. 2007;374(1):60-70. [Crossref]  [PubMed]
  36. Cowan BD, Vandermolen DT, Long CA, Whitworth NS. Receiver-operator character- istic, efficiency analysis, and predictive value of serum progesterone concentration as a test for abnormal gestations. Am J Ob- stet Gynecol. 1992;166(6 Pt 1):1729-34. [Crossref]
  37. Arck PC, Rücke M, Rose M, Szekeres-Bartho J, Douglas AJ, Pritsch M, et al. Early risk fac- tors for miscarriage: a prospective cohort study in pregnant women. Reprod Biomed Online. 2008;17(1):101-13. [Crossref]