| Objectives:1.To explore the possible elements in ambient PM2.5causing adverse pregnancy outcome through analyzing the concentration of elements in PM2.5and the occurrences of the adverse pregnancy outcomes between a nickel-contaminated area and control area.2. To discuss the relationship between elements concentration in cord blood and venous blood of pregnant women and the concentration of elements in PM2.5,and the barrier function of placental barriers to cobalt (Co), nickel (Ni), copper (Cu), arsenic (As) and selenium (Se) by analyzing and comparing the five elements concentration in blood between the nickel-contaminated area and control area.Methods:1.Two cities were selected as the nickel-contaminated area and control area, and ambient PM2.5in their communities were collected and the elements concentrations in ambient PM2.5were analyzed with X-ray fluorescence spectrometer from March2009to April of2010and found the main difference of the elements in PM2.5between two sites, and inpatient delivery data of pregnancy women from these two areas were collected Simultaneously and the occurrences of the adverse pregnancy outcome were analyzed.2. Thirty healthy pregnant women and their newborns were selected through the questionnaire with physical examination and test, age and body mass index matched between the two areas, maternal venous blood and fetal cord blood were respectively collected before and at delivery respectively. The concentration of Co, Ni, Cu, As and Se were determined with the inductively coupled plasma mass spectrometer (ICP-MS) and were assessed the differences between the two areas and correlation between maternal and cord blood.Results: 1. The results of the effection between certain elements in ambient PM2.5and the adverse pregnancy outcome in nickel-contaminated area(1) The concentrations of Co, Ni, Cu, As and Se in ambient air in the nickel-contaminated area, were found to be higher in PM2.5than that in the control area, and the former were4times,82times,26times,12times and6times as the latter respectively, but the levels of other elements were similar between the two regions.(2) The incidence of the adverse pregnancy outcomes in the nickel-contaminated area was significantly higher than that in the control area (x2=161.26, P<0.01); in both areas, the incidence of adverse pregnancy outcomes was the higher in under20and over35years old; there were statistically significant difference among age groups(P<0.01); at the same age group, the incidence of adverse pregnancy outcomes in the nickel-contaminated area were significantly higher than that in the control area (P<0.01,P<0.05).(3) With the increase of gravidity, parity and abortions rates, the incidence of adverse pregnancy outcomes in the two regions showed an upward trend (P<0.01); the incidence of adverse pregnancy outcomes in the nickel-contaminated area were significantly higher than that in the control area (P<0.01, P<0.05) at the same gravidity, parity and abortions rates.(4) The incidence of adverse pregnancy outcomes in the pregnant women giving birth by cesarean section was higher than that in the pregnant women by natural labor (P<0.01); the incidence of adverse pregnancy outcomes in the nickel-contaminated area were significantly higher than that in the control area (P<0.01) in the same delivery mode.(5) The incidence of adverse pregnancy outcomes in the pregnant women with high-risk situations in the two regions was significantly higher than that without it(P<0.Ol); the incidence of adverse pregnancy outcomes in the nickel-contaminated area were significantly higher than that in the control area (P<0.01) at the same situation.(6) The incidence of premature birth, low birth weight, still births, stillbirth and birth defects in nickel-contaminated area were significantly higher than that in the control area (P<0.01); however, there was no statistically difference in the incidence of giant infant and neonatal asphyxia between the two regions (P>0.05).(7) The incidence of low birth weight in the age of under20years old in the nickel-contaminated area was significantly higher than that in the control area (P<0.05); the incidence of premature birth, low birth weight, still births, stillbirth and birth defects in the pregnant women aged20to24in the nickel-contaminated area were significantly higher than that in the control area (P<0.01); the incidence of premature birth, low birth weight, still births, stillbirth and birth defects of pregnant women aged25to29in the nickel-contaminated area were significantly higher than that in the control area (P<0.01); the incidence of premature birth and low birth weight of pregnant women aged30to49in the nickel-contaminated area were significantly higher than that in the control area (P<0.01); the incidence stillbirths and deadbirth rate of pregnant women aged over35years old in the nickel-contaminated area were significantly higher than that in the control area (P<0.01); there was no statistical difference in the rest between the two regions (P>0.05).(8)The incidence of premature birth, low birth weight in the nickel-contaminated area were significantly higher than that in the control area at the first gestation group (P<0.01); the incidence of low birth weight, still births, stillbirth birth defects in the nickel-contaminated area were significantly higher than that control area at two gestation time group (P<0.01); the incidence of preterm birth in the nickel-contaminated area was significantly higher than that in the control area in three and above three gestation time groups (P<0.01); there was no statistical difference in the rest between the two regions (P>0.05).(9)The incidence of premature birth, low birth weight, stillbirth, deadbirth and birth defects in the nickel-contaminated area were significantly higher than that in the control area in zero birth time group (P<0.01); the incidence of preterm birth in the nickel-contaminated area was significantly higher than that in the control area in one birth time group (P<0.01); the incidence of premature birth and birth defects in the nickel-contaminated area were significantly higher than that in the control area in two and above two birth time groups (P<0.01); there was no statistical difference in the rest between the two regions (P>0.05).(10) The incidence of premature birth, low birth weight, stillbirth and birth defects in the nickel-contaminated area were significantly higher than that in the control area in zero abortion time group (P<0.01); the incidence of premature birth and low birth weight in the nickel-contaminated area were significantly higher than that in the control area in one abortion time groups (P<0.01); the incidence of preterm birth in the nickel-contaminated area was significantly higher than that in the control area in two abortion time groups (P<0.05); the incidence of premature birth and birth defects in the nickel-contaminated area were significantly higher than that in the control area in three and above three abortion time groups (P<0.05, P<0.01); there was no statistical difference in the rest between the two regions (P>0.05).(11) The incidence of adverse pregnancy outcomes among the natural labor of pregnant women in the nickel-contaminated area were significantly higher than that in the control area (P<0.01, P<0.05); the incidence of premature birth, low birth weight, still births, stillbirth and birth defects among the cesarean section of pregnant women in the nickel-contaminated area were significantly higher than that in the control area (P<0.01, P<0.05); however, there was no statistically difference in the incidence of giant infant and neonatal asphyxia between two regions (P>0.05).(12)The incidence of premature birth, low birth weight, stillbirths, deadbirth and birth defects of normal pregnant women in the nickel-contaminated area were significantly higher than that in the control area (P<0.01); the incidence of premature birth, low birth weight of high-risk pregnant women in nickel-contaminated area were significantly higher than that in the control area (P<0.01, P<0.05); there was no statistical difference in the rest between the two regions (P>0.05).(13) The rate of cesarean section in the nickel-contaminated area was significantly lower than that in the control area (x2=59.62, P<0.01); the abortion rate in the nickel-contaminated area was significantly higher than that in the control area (x2=10.81, P<0.01); the incidence of pregnancy with cholestasis, anemia, premature rupture of membranes in the nickel-contaminated area were significantly higher than that in the control area (P<0.01); the incidence of pregnancy-induced hypertension, abnormal placenta in the control area was significantly higher than that in nickel-contaminated areas (P<0.05, P<0.01).(14) The incidence of fetal with intrauterine growth retardation and fetal distress in the nickel-contaminated area were significantly higher than that in the control area (P<0.01), while there was no statistical difference in the incidence of others between the two regions (P>0.05).2. The effect of placental to the trace elements in pregnant women bodies(1)The levels of Co, Ni, Cu, As and Se both in the maternal blood and cord blood in the nickel-contaminated area were higher than that in the control area, there were significant differences in the levels of Co, As, Se between the two areas (P<0.01), there was no significant difference in Ni (P>0.05); there was significant difference in the concentration of Cu in cord blood (P<0.05), but no statistical significant in matermal blood between the two areas(P>0.05).(2) In the nickel-contaminated area, the levels of Ni, As, Se in umbilical cord blood were significantly higher than that in maternal blood (P<0.01, P<0.05), the levels of Cu elements in cord blood were significantly lower than that in maternal blood (P<0.01), the concentration of Co was similar in both blood (P>0.05); in the control area, the level of Ni in cord blood was significantly higher than that in maternal blood (P<0.05), the level of Cu in cord blood was significantly lower than that in maternal blood (P<0.01), the concentration of Co, As, Se were similar in both blood (P>0.05).(3) In the same area, the concentration ratio of Co, Ni, As, Se in cord blood to maternal blood were equal or greater than1, and the concentration ratio of Cu was less than1; there were no significantly difference in the ratios of each element in the cord blood to maternal blood between the nickel-contaminated area and control area (P>0.05).(4) There were significantly positive correlation in the levels of Co, Cu, As and Se (P<0.01, P<0.05) between maternal blood and cord blood, and the correlation coefficient were0.334,0.479,0.269,0.350; but no correlation in Ni (P>0.05).Conclusion:1. The main different elements of PM2.5were Co, Ni, Cu, As and Se between the nickel-contaminated area and control areas, there concentration were higher in the nickel-contaminated area than in the control areas. The incidence of adverse pregnancy outcome in nickel-contaminated area was significantly higher than in control areas; Ni may be the potential pathogenic element in the adverse pregnancy outcome caused by PM2.5.2. The higher levels of Co, Ni, Cu, As, Se in the body of pregnant women may be due to the exposure of elements in ambient PM2.5; placental barriers cannot effectively prevent Co, Ni, As, Se elements except Cu in PM2.5from transfering from mother to fetus, and nickel showed highly cumulative characteristics in the fetal. |
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