JCOG 2019;29(1):31-8 31 nvironmental pollution and industrialization expose humans to heavy metals in every period of their lives. Exposure to heavy metals affects the growth and development of a living being; therefore, it has be- come increasingly alarming in terms of public health. One of the environ- mental factors responsible for decreasing the chances of a healthy pregnancy and thus preventing a healthy birth is heavy metals. Both maternal and pa- ternal heavy metal exposure may affect pregnancy. Occupational exposures to heavy metals have been associated with poor obstetric outcomes and ad- verse effects on female fertility. Heavy metals have been proved to be environmental pollutants for all living creatures and humans. They may be present in the environment ei- ther naturally, or as industrial pollutants resulting from industrial accidents and various other reasons. The levels of heavy metals in blood have been found to be higher in countries with greater industrial development. 1 Miscarriage is defined as a pregnancy that is spontaneously lost before 22 weeks of gestation and below 500 g fetal weight. Spontaneous abortion is largely becoming a public health concern for developing countries. 2 Early pregnancy loss includes gestational sac that is empty before 12 6/7 weeks of gestation or the presence of an embryo or fetus without cardiac The Effect of Heavy Metals on Miscarriage ABSTRACT Objective: In a world where industrial pollution is increasing day by day, heavy met- als are one of the important factors threatening human health. The rates of pregnancy loss and sub- fertility are continuously increasing. This study aims to explain the effects of lead (Pb), cadmium (Cd), and mercury (Hg) levels on the etiology of abortions. Material and Methods: The study was designed as a case-control study with two groups: healthy volunteers (n=20) and miscarriage (n=29) group. The pregnant women with similar demographic characteristics were divided into two groups and peripheral venous blood samples of the study subjects were collected. Atomic absorption spec- trophotometer was used to examine the blood samples and the levels of heavy metal. Results: While the Pb level was found to be higher in the miscarriage group (p=0.038), there was no statistical dif- ference between Cd and Hg levels (p>0.005) in the two groups. On comparing the laboratory val- ues of pregnant women in the control and miscarriage groups, blood progesterone values were observed to be lower in the miscarriage group (p<0.001). Conclusion: This study indicates that heavy metals, even below the toxic dose limits, can cause miscarriage. Higher blood Pb levels were found in the miscarriage group while Hg and Cd levels were not different between the two groups. This research points out that the high levels of lead may have an effect on pregnancy loss. Keywords: Miscarriage; heavy metals; lead; cadmium, mercury Engin YILDIRIM a , Mehmet Kürşat DERİCİ b a Department of Gynecology and Obstetrics, Hitit University Faculty of Medicine, Çorum, TURKEY b Department of Medical Pharmacology, Kırıkkale University Faculty of Medicine, Kırıkkale, TURKEY Received: 09.12.2018 Received in revised form: 28.01.2019 Accepted: 13.02.2019 Available online: 26.02.2019 Correspondence: Engin YILDIRIM Hitit University Faculty of Medicine, Department of Gynecology and Obstetrics, Çorum, TURKEY dreyildirim@gmail.com Copyright © 2019 by Türkiye Klinikleri DOI: 10.5336/jcog.2018-64175 ORIGINAL RESEARCH