Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Department of Civil and Environmental Engineering, School of Engineering, Tufts University, Medford, Massachusetts, USA.
Environ Health Perspect. 2021 May;129(5):57006. doi: 10.1289/EHP7502. Epub 2021 May 14.
Studies have evaluated environmental exposure to toxic metals such as arsenic (As), cadmium (Cd), manganese (Mn), or lead (Pb) on birth size; however, information on potential effects of exposures to metal mixtures is limited.
We assessed the association between metal mixtures (As, Cd, Mn, Pb) in umbilical cord blood and neonate size in Bangladeshi children.
In this birth cohort study, pregnant women who were of age with an ultrasound-confirmed singleton pregnancy of gestation were recruited from two Bangladesh clinics between 2008 and 2011. Neonate size metrics were measured at the time of delivery. Metals in cord blood were measured using inductively coupled plasma mass spectrometry. We employed multivariable linear regression and Bayesian kernel machine regression (BKMR) to estimate associations of individual metals and metal mixtures with birth size parameters.
Data from 1,088 participants was assessed. We found a significant negative association between metal mixture and birth length and head circumference when all metal concentrations were above the 60th and 55th percentiles, respectively, compared with the median. An interquartile range (IQR) increase in log Cd concentration {log[Cd (in micrograms per deciliter)] } was associated with a 0.13-standard deviation (SD) decrease in mean birth length (95% CI: , ) and a 0.17-SD decrease in mean head circumference (95% CI: , ), based on linear regression models adjusted for covariates and the other metals. An IQR increase in log Mn concentration {log[Mn (in micrograms per deciliter)] } was associated with a 0.07-SD decrease in mean birth weight (95% CI: , 0.002).
Metal mixtures in cord blood were associated with reduced birth size in Bangladeshi children. Results from linear regression models adjusted and the BKMR mixtures analyses suggest adverse effects of Cd and Mn, as individual metal exposures, on birth size outcomes. https://doi.org/10.1289/EHP7502.
已有研究评估了环境暴露于砷（As）、镉（Cd）、锰（Mn）或铅（Pb）等有毒金属对出生体重的影响；然而，关于金属混合物潜在影响的信息有限。
我们评估了脐带血中金属混合物（As、Cd、Mn、Pb）与孟加拉国儿童新生儿大小的关系。
在这项出生队列研究中，我们招募了 2008 年至 2011 年间在孟加拉国两家诊所妊娠的年龄在 15-44 岁之间、超声确认单胎妊娠且孕周在 12-36 周的孕妇。在分娩时测量新生儿大小指标。使用电感耦合等离子体质谱法测量脐带血中的金属。我们采用多元线性回归和贝叶斯核机器回归（BKMR）来估计单个金属和金属混合物与出生大小参数的关联。
评估了 1088 名参与者的数据。我们发现，当所有金属浓度分别高于第 60 百分位数和第 55 百分位数时，与中位数相比，金属混合物与出生长度和头围呈显著负相关。与线性回归模型调整协变量和其他金属相比，log[Cd（每分升微克）]浓度的一个四分位距（IQR）增加与平均出生长度（95%CI：，）减少 0.13 个标准差（SD）和平均头围（95%CI：，）减少 0.17 SD 相关。log[Mn（每分升微克）]浓度的一个 IQR 增加与平均出生体重（95%CI：，0.002）减少 0.07 SD 相关。
脐带血中的金属混合物与孟加拉国儿童出生体重降低有关。调整后的线性回归模型和 BKMR 混合物分析结果表明，Cd 和 Mn 作为个体金属暴露，对出生体重结局有不良影响。https://doi.org/10.1289/EHP7502.
