PMID- 35219936 OWN - NLM STAT- MEDLINE DCOM- 20220428 LR - 20220428 IS - 1873-6750 (Electronic) IS - 0160-4120 (Linking) VI - 162 DP - 2022 Apr TI - Exposure to multiple trace elements and miscarriage during early pregnancy: A mixtures approach. PG - 107161 LID - S0160-4120(22)00087-3 [pii] LID - 10.1016/j.envint.2022.107161 [doi] AB - BACKGROUND: Exposure to some conventional trace elements has been found to be associated with miscarriage; however, evidence for combined exposure is inconclusive. Therefore, it is important to explore the joint associations between toxic and essential trace elements and miscarriage. METHODS: This cross-sectional study measured a wide range of element levels in the whole blood of pregnant women by using inductively coupled plasma mass spectrometry. The associations between individual elements and miscarriage were appraised using logistic regression model. Multi-exposure models, including Bayesian kernel machine regression (BKMR) and weighted quantile sum regression (WQS), were used to explore the mixed exposure to elements. Furthermore, grouped weighted quantile sum (GWQS) considered multiple elements with different magnitudes and directions of associations. RESULTS: In logistic regression, the odds ratios (ORs) with a 95% confidence interval (CI) in the highest quartiles were 5.45 (2.00, 15.91) for barium, 0.28 (0.09, 0.76) for copper, and 0.32 (0.12, 0.83) for rubidium. These exposure-outcome associations were confirmed and supplemented by BKMR, which indicated a positive association for barium and negative associations for copper and rubidium. In WQS, a positive association was found between mixed elements and miscarriage (OR: 1.71; 95% CI: 1.07, 2.78), in which barium (75.7%) was the highest weighted element. The results of GWQS showed that the toxic trace element group dominated by barium was significantly associated with increased ORs (OR: 2.71; 95% CI: 1.74, 4.38). Additionally, a negative association was observed between the essential trace element group and miscarriage (OR: 0.32; 95% CI: 0.18, 0.54), with rubidium contributing the most to the result. CONCLUSIONS: As a toxic trace element, barium was positively associated with miscarriage both by individual and multiple evaluations, while essential trace elements, particularly rubidium and copper, exhibited negative associations. Our findings provide significant evidence for exploring the effects of trace elements on miscarriage. CI - Copyright (c) 2022 The Authors. Published by Elsevier Ltd.. All rights reserved. FAU - Lu, Yingying AU - Lu Y AD - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. FAU - Zhang, Yuqing AU - Zhang Y AD - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. FAU - Guan, Quanquan AU - Guan Q AD - State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China. FAU - Xu, Lu AU - Xu L AD - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. FAU - Zhao, Shuangshuang AU - Zhao S AD - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. FAU - Duan, Jiawei AU - Duan J AD - State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China. FAU - Wang, Yan AU - Wang Y AD - Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. FAU - Xia, Yankai AU - Xia Y AD - State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China. Electronic address: yankaixia@njmu.edu.cn. FAU - Xu, Qing AU - Xu Q AD - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China; State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China. Electronic address: xuqing@njmu.edu.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220224 PL - Netherlands TA - Environ Int JT - Environment international JID - 7807270 RN - 0 (Trace Elements) RN - 24GP945V5T (Barium) RN - 789U1901C5 (Copper) RN - MLT4718TJW (Rubidium) SB - IM MH - *Abortion, Spontaneous/epidemiology MH - Barium MH - Bayes Theorem MH - Copper MH - Cross-Sectional Studies MH - Female MH - Humans MH - Pregnancy MH - Rubidium MH - *Trace Elements OTO - NOTNLM OT - Bayesian kernel machine regression (BKMR) OT - Grouped weighted quantile sum (GWQS) OT - Miscarriage OT - Mixed exposure OT - Trace element OT - Weighted quantile sum (WQS) EDAT- 2022/02/28 06:00 MHDA- 2022/04/29 06:00 CRDT- 2022/02/27 20:30 PHST- 2021/10/08 00:00 [received] PHST- 2022/02/19 00:00 [revised] PHST- 2022/02/21 00:00 [accepted] PHST- 2022/02/28 06:00 [pubmed] PHST- 2022/04/29 06:00 [medline] PHST- 2022/02/27 20:30 [entrez] AID - S0160-4120(22)00087-3 [pii] AID - 10.1016/j.envint.2022.107161 [doi] PST - ppublish SO - Environ Int. 2022 Apr;162:107161. doi: 10.1016/j.envint.2022.107161. Epub 2022 Feb 24.