Abstract
Background
Exposure to metals during pregnancy has been found to be associated with adverse birth outcomes in the fetus. However, evidence for combined exposure is inconclusive. Therefore, it is important to explore the correlation between the combined effects of mixed metallic elements and adverse birth outcomes.
Objectives
The aim of this study was to investigate the association between maternal serum heavy metals concentrations in the second trimester of pregnancy and adverse neonatal outcomes, including PTB, birth defects, LBW, macrosomia, SGA and LGA.
Methods
Specifically, we examined the serum levels of various elements in pregnant women during mid-pregnancy, using the highly sensitive inductively coupled plasma mass spectrometer (ICP-MS). This study utilized advanced multiple exposure models, including Bayesian kernel machine regression (BKMR) and weighted quantile sum regression (WQS), to analyze the mixed exposure to elements.
Results
Both BKMR and WQS models showed that mixed metal exposure was positively associated with PTB, but negatively associated with birth defects and LGA. Tl and Fe were negatively associated with PTB, Se, Sb, and I were positively associated with PTB, and Se and Rb were negatively associated with birth defects. WQS regression analysis showed that metal mixed exposure was positively associated with preterm birth (p = 0.043) and negatively associated with LGA (p = 0.015).
Conclusions
The findings from this study contribute valuable insights into the potential health risks associated with mixed metals exposure during pregnancy. By elucidating the multifaceted impacts of metal mixtures on birth outcomes, this research offers a foundation for developing targeted interventions and preventive measures to safeguard maternal and child health.