Impact of ecotoxicity on oxidative stress, renal dysfunction, and hepatic dysfunction in pregnant women in Kinshasa during the COVID-19 pandemic period/2020-2021

Background The COVID-19 pandemic has potentially increased environmental exposure to heavy metals, which are pro-oxidant agents. Their impact on oxidative stress ("stress-toxicity") and hepatorenal health in pregnant women, a vulnerable population, remains poorly documented in the Democratic Republic of Congo.To assess the association between heavy metal exposure, stress-toxicity, and markers of hepatic and renal dysfunction in pregnant women in Kinshasa. Methods A cross-sectional study included 473 pregnant women. Stress-toxicity status was defined by biochemical criteria. Serum concentrations of 11 heavy metals, along with hepatic and renal biochemical parameters, were measured. Statistical analyses, including correlations and ROC curves, were performed. Results The prevalence of stress-toxicity was 8.2% (39/473). The groups with and without stress-toxicity were comparable for age and BMI. The stress-toxicity (+) group had significantly higher levels of uric acid (5.7 vs 3.7 mg/dL, p < 0.001), triglycerides, ASAT, PAL, and a higher prevalence of hyperuricemia (79.5% vs 10.8%), hypoalbuminemia (25.6% vs 4.8%), and hepatic dysfunction (89.7% vs 14.1%). Concentrations of vanadium, nickel, lead, and iron were significantly higher in women with stress-toxicity (p < 0.001) and strongly correlated with it (Tau-B from 0.111 to 0.365). ROC analyses identified lead (AUC = 0.960), vanadium (AUC = 0.949), and nickel (AUC = 0.940) as excellent diagnostic biomarkers for stress-toxicity. Conclusion Exposure to heavy metals, particularly lead, vanadium, and nickel, is strongly associated with stress-toxicity and hepatorenal comorbidities in pregnant women in Kinshasa. Measuring these metals could serve as an early screening tool to identify high-risk patients.