Preeclampsia and toxic metals: a case-control study in Kinshasa, DR Congo

Environmental Health

Research

Bernard Spitz¹  Barthélémy Tandu-Umba²  Baudouin Buassa-bu-Tsumbu²  Jean-Pierre Elongi Moyene³  Benoit Nemery⁴  Hans Scheers⁴  Fons Verdonck⁵  Vincent Haufroid⁶ 

[1] Department of Development and Regeneration (Pregnancy, Foetus and Newborn), KU Leuven, Leuven, Belgium;Division of Gynecology and Obstetrics, UZ Leuven, Leuven, Belgium;Department of Gynecology and Obstetrics, University of Kinshasa, and General Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo;Department of Gynecology and Obstetrics, University of Kinshasa, and General Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo;Hôpital Général de Kinshasa, Avenue de l’Hôpital, Commune de la Gombe, Kinshasa, DR, Congo;Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium;Faculty of Medicine, KU Leuven, Leuven, Belgium;Louvain centre for Toxicology and Applied Pharmacology, Institut de recherche expérimentale et clinique, Université catholique de Louvain, Brussels, Belgium;

关键词: Metal pollution;    Lead;    Preeclampsia;    Hypertension;    Seasonality;    Developing country;    Global health;   

DOI  :  10.1186/s12940-016-0132-1

 received in 2015-07-29, accepted in 2016-03-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPreeclampsia is frequent in Kinshasa (Democratic Republic of Congo), especially during the dry season. We tested whether preeclampsia was associated with exposure to environmental metals.MethodsUsing a case-control design, 88 women hospitalized with preeclampsia (cases) and 88 healthy pregnant women from the antenatal clinic (controls) were included in the study; 67 and 109 women were enrolled during the rainy and dry season, respectively. The concentrations of 24 elements were quantified by inductively coupled plasma mass spectrometry (ICP-MS) in 24-h urine collections. Differences in the urinary excretion of metals were investigated between cases and controls, and the interaction with season was assessed.ResultsCases and controls were well matched regarding age, parity and duration of pregnancy. In controls, the urinary concentrations of most elements were substantially higher than reference values for adults from industrially developed countries, e.g. for lead: geometric mean (GM) 8.0 μg/L [25th-75th percentile 3.1–13.8]. The daily urinary excretions of 14 metals were significantly higher in women with preeclampsia than in control women, e.g. for lead: GM 61 μg/day (25th–75th percentile 8–345) in women with preeclampsia vs 9 μg/day (25th–75th percentile 3–21) in controls (p < 0 · 001). A significant interaction was found between season and preeclampsia for several elements, with higher urinary excretions in preeclamptic women than controls during the dry season, but not during the rainy season.ConclusionsThis study revealed not only that women with preeclampsia excrete higher amounts of several toxic metals, especially lead, than control women, but also that this excretion exhibits seasonal variation, thus possibly explaining the high incidence and seasonal variation of preeclampsia in Kinshasa. Although the exact sources of this exposure are unknown, these findings underscore the need for preventing environmental exposures to lead and other toxic metals.

【 授权许可】

CC BY   
© Elongi Moyene et al. 2016