Inadera Hidekuni, Takamori Ayako, Matsumura Kenta, Tsuchida Akiko, Cui Zheng-Guo, Hamazaki Kei, Tanaka Tomomi, Ito Mika, Kigawa Mika, Origasa Hideki, Michikawa Takehiro, Nakayama Shoji F, Isobe Tomohiko, Takeuchi Ayano, Sato Tosiya, Nitta Hiroshi, Yamazaki Shin
Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
Toyama Regional Center for JECS, University of Toyama, Toyama, Japan; Clinical Research Center, Saga University Hospital, Saga, Japan.
Environ Res. 2020 Dec;191:110007. doi: 10.1016/j.envres.2020.110007. Epub 2020 Aug 5.
There is growing evidence of an association between cadmium (Cd) and unfavorable birth outcomes. The effect of Cd exposure on anthropometric measures at birth or small for gestational age (SGA) infants in a large, nationwide Japanese cohort remains to be clarified.
To analyze the association between maternal blood Cd levels at different sampling times and sex-dependent infant birth size, weight, body length, chest, and head circumferences, in addition to SGA.
Data of 17,584 pregnant women in the Japan Environment and Children's Study were analyzed for anthropometric measurements. For SGA determination, 13,969 cases of vaginal delivery were analyzed after excluding infants born by cesarean section. Maternal blood Cd levels were categorized into quartiles (Q1-Q4), and the Q1 was used as a reference. Multiple linear regression analysis was performed for anthropometric measurements, and multiple logistic regression analysis was used to investigate the association of maternal blood Cd levels with the risk of SGA.
Birth weight tended to decrease according to the increase in quartiles of blood Cd levels (15.63 g decrease [95% confidence level (CI): -33.26, 2.01] for Q4). The overall analysis revealed no decreases in body length and head and chest circumference, but subgroup analysis revealed that chest circumference tended to decrease according to the increase in quartiles in the female sex/third-trimester stratification (0.16 cm decrease [95% CI: -0.32, 0.00] for Q4). SGA risk was also higher and paralleled the increase in blood Cd levels associated with the female sex/third-trimester group (Odds Ratio 1.90 [95% CI: 1.23, 2.94] for Q4).
Our results provide further evidence of sex-specific health risks associated with Cd exposure in early life in a large Japanese pregnancy cohort.
越来越多的证据表明镉（Cd）与不良出生结局之间存在关联。在日本一个大型全国性队列中，镉暴露对出生时人体测量指标或小于胎龄（SGA）婴儿的影响仍有待阐明。
分析不同采样时间孕妇血镉水平与性别相关的婴儿出生大小、体重、身长、胸围和头围以及小于胎龄儿之间的关联。
对日本环境与儿童研究中17584名孕妇的人体测量数据进行分析。对于小于胎龄儿的判定，排除剖宫产出生的婴儿后，对13969例阴道分娩病例进行分析。孕妇血镉水平分为四分位数（Q1-Q4），并将Q1用作参照。对人体测量指标进行多元线性回归分析，采用多元逻辑回归分析来研究孕妇血镉水平与小于胎龄儿风险之间的关联。
出生体重倾向于随着血镉水平四分位数的增加而降低（Q4时降低15.63克[95%置信区间（CI）：-33.26，2.01]）。总体分析显示身长、头围和胸围没有降低，但亚组分析显示，在女性/孕晚期分层中，胸围倾向于随着四分位数的增加而降低（Q4时降低0.16厘米[95%CI：-0.32，0.00]）。小于胎龄儿风险也更高，且与女性/孕晚期组血镉水平的升高平行（Q4时优势比为1.90[95%CI：1.23，2.94]）。
我们的结果为日本一个大型妊娠队列中早期生活镉暴露相关的性别特异性健康风险提供了进一步证据。
