PMID- 38099181 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231216 IS - 2296-861X (Print) IS - 2296-861X (Electronic) IS - 2296-861X (Linking) VI - 10 DP - 2023 TI - Individual and combined association between nutritional trace metals and the risk of preterm birth in a recurrent pregnancy loss cohort. PG - 1205748 LID - 10.3389/fnut.2023.1205748 [doi] LID - 1205748 AB - 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 25(th) and 50(th) 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. CI - Copyright (c) 2023 Liu, Wang, Ge, Shen, Li and Qiao. FAU - Liu, Yilin AU - Liu Y AD - Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China. AD - Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China. AD - Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China. AD - Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China. FAU - Wang, Tingting AU - Wang T AD - Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China. AD - Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China. AD - Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China. AD - Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China. FAU - Ge, Yunpeng AU - Ge Y AD - Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China. AD - Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China. AD - Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China. AD - Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China. FAU - Shen, Hongfei AU - Shen H AD - Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China. AD - Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China. AD - Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China. AD - Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China. FAU - Li, Jiapo AU - Li J AD - Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China. AD - Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China. AD - Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China. AD - Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China. FAU - Qiao, Chong AU - Qiao C AD - Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China. AD - Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China. AD - Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China. AD - Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China. LA - eng PT - Journal Article DEP - 20231130 PL - Switzerland TA - Front Nutr JT - Frontiers in nutrition JID - 101642264 PMC - PMC10720726 OTO - NOTNLM OT - Bayesian kernel machine regression OT - metal mixture OT - nutritional trace metals OT - preterm birth OT - recurrent pregnancy loss COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/12/15 06:42 MHDA- 2023/12/15 06:43 PMCR- 2023/01/01 CRDT- 2023/12/15 04:01 PHST- 2023/04/14 00:00 [received] PHST- 2023/10/30 00:00 [accepted] PHST- 2023/12/15 06:43 [medline] PHST- 2023/12/15 06:42 [pubmed] PHST- 2023/12/15 04:01 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fnut.2023.1205748 [doi] PST - epublish SO - Front Nutr. 2023 Nov 30;10:1205748. doi: 10.3389/fnut.2023.1205748. eCollection 2023.