Environmental carbon monoxide related to pregnancy hypertension.

Carbon monoxide pollution frequently occurs due to auto exhaust, industrial emissions, and/or cigarette smoke. Exogenous and endogenous carbon monoxide affects blood pressure; however, the relation of carbon monoxide exposure to pregnancy hypertension has not been systematically examined. For the present study the authors recruited a total of 2,707 apparently healthy, non-obese, non-smoking mothers, aged between 15 and 40 years, who had singleton births, and who lived within two miles of the selected air monitoring stations in Tehran, Iran, to study the relation of ambient carbon monoxide to pregnancy hypertension (>140 mmHg systolic and/or >90 mmHg diastolic after the 20th week of gestation). A relatively small but statistically significant elevation in mean postpartum diastolic blood pressure (mean ± SD, 69.5 ± 9.8 mmHg) was observed in the mothers' who were exposed to relatively high ambient carbon monoxide (mean = 14.1 ppm) compared to mothers exposed to lower carbon monoxide (mean = 1.8 ppm) concentrations (mean ± SD, 68.0 ± 8.3 mmHg, p < 0.01). The authors found twice the rate of pregnancy hypertension in the relatively higher carbon monoxide exposed mothers than the mothers with lower exposure (adjusted odds ratio = 2.02, 95% CI 1.35-3.03). Findings of the present study suggest that high level ambient carbon monoxide exposure is associated with pregnancy hypertension.

Blood manganese concentrations and intrauterine growth restriction.

To assess the relationship between blood concentrations of manganese (Mn) and intrauterine growth restriction (IUGR), Mn levels in the umbilical cord blood (UCB) and the mother whole blood (MWB) samples were measured in apparently healthy mothers and their newborns. Measurement was conducted by an inductively coupled plasma mass spectrometry. Manganese concentrations in MWB were significantly lower (p<0.01) in IUGR cases than in appropriate for gestational age (AGA) cases (mean+/-S.D.; 16.7+/-4.8 and 19.1+/-5.9 microg/l, respectively). Conversely, UCB concentrations of Mn were significantly higher (p<0.05) in IUGR newborns than AGA newborns (44.7+/-19.1 and 38.2+/-13.1 microg/l, respectively). Logistic regression analysis demonstrated significant relationships of the mother whole blood and the umbilical cord blood concentrations of Mn in IUGR cases (OR=0.868, 1.044, respectively). The study suggests that manganese concentrations in MWB and UCB might induce different effects on birth weight in healthy mothers. Because intrauterine growth restriction is a multi-factorial problem, further epidemiological and clinical studies on larger numbers of subjects are needed to confirm the findings in the present study.

Lead and other trace metals in preeclampsia: a case-control study in Tehran, Iran.

To assess the effects of environmental exposures to trace metals on the incidence of preeclampsia, concentrations of lead (Pb), antimony (Sb), manganese (Mn), mercury, cadmium, cobalt and zinc in umbilical cord blood (UCB) and mother whole blood (MWB) were measured in 396 postpartum women without occupational exposure to metals in Tehran, Iran, using inductively coupled plasma mass spectrometry. Mother's ages ranged from 15 to 49 (mean 27) years. Preeclampsia was diagnosed in 31 subjects (7.8%). Levels of Pb, Sb and Mn in UCB were significantly higher in preeclampsia cases [mean+/-SD of 4.30+/-2.49 microg/dl, 4.16+/-2.73 and 46.87+/-15.03 microg/l, respectively] than in controls [3.52+/-2.09 microg/dl, 3.17+/-2.68 and 40.32+/-15.19 microg/l, respectively] (P<0.05). The logistic regression analysis revealed that one unit increase in the common logarithms of UCB concentration of Pb, Sb or Mn led to increase in the risk of preeclampsia several-fold; unit risks (95% CI) were 12.96 (1.57-107.03), 6.11 (1.11-33.53) and 34.2 (1.81-648.04) for Pb, Sb and Mn, respectively (P<0.05). These findings suggest that environmental exposure to Pb, Sb and Mn may increase the risk of preeclampsia in women without occupational exposure; levels of metals in UCB to be sensitive indicators of female reproductive toxicity as compared with those in mother MWB. Further studies are necessary to confirm these findings, especially on Sb and Mn.

Prevalence of human papillomavirus genotypes in women with normal and abnormal cervical cytology in Iran.

INTRODUCTION: HPV infection has a prime etiologic role in development and progression of cervical cancer, one of the most frequent forms of cancer among women in developing countries. This study was designed to determine the most prevalent HPV genotypes in women with normal and abnormal cervical cytology in Iran. MATERIALS AND METHODS: Samples from134 patients, including 127 who attended gynecology clinics and 7 with solid cervical tumors were used. All 127 patients underwent routine Pap tests for cytological evaluation and at the same visit a sample of cervical epithelial cells was obtained by scraping the cervix osteum. In each case HPV infection was primarily evaluated by PCR using GP 5/6 primers and then subtyping was performed in proved infected samples with specific primers for HPV 16, 18, 31, 33, 11 and 6. After cytological evaluation, 50 patients with abnormal Pap tests were categorized as the abnormal group and the remaining 77 patients as the normal group. RESULTS: In the normal group, HPV infection was established in 10 cases (13% infection rate), while 30 HPV positive cases were discovered in the abnormal group (60% infected). The most prevalent genotypes among the infected samples were HPV 16 (76%), HPV18 (12.7%) and HPV11/6 (8.5%). Moreover, all 7 tumor samples were positive for HPV general primers of which, 5 samples were infected with HPV 16, two were co-infected with HPV16,18 and HPV16,31 genotypes and one was infected with HPV 18. CONCLUSIONS: Infection with HPV 16 was found to be significantly higher in abnormal group in comparison with normal group (42% vs. 11.6%, P value <0.005), likewise HPV18 genotypes were proved to be more prevalent in abnormal group (8% vs. 0%, P value <0.05). No significant relation between other HPV genotypes and pathologic cervical changes was obtained. According to our study high rates of infection with HPV genotypes in sexually active Iranian women makes molecular investigation for HPV16 and 18 very essential in clinical approaches to patients with proven dysplasia in their screening tests and also for those patients with borderline (i.e. ASCUS) or incongruous pathology reports. Larger studies are required to determine the most appropriate vaccine with highest protection in Iranian women.