Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan.
Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
Environ Int. 2022 Jul;165:107318. doi: 10.1016/j.envint.2022.107318. Epub 2022 May 23.
Growth restriction in the prenatal period is a significant public health concern. Metals can negatively affect birth size, and pregnant women may be exposed to metal mixtures. Comprehensive studies analyzing the effects of combined metal exposure with accurate individual blood metal concentrations are limited. The current study investigated the associations between maternal metal exposure and birth size in a large, nationwide Japanese cohort using individual and mixed model approaches.
Lead, cadmium, mercury, selenium, and manganese blood concentrations were measured in pregnant women in the Japan Environment and Children's Study (JECS). Measurements of infant birth size-including body weight, body length, and head and chest circumference-were collected. Linear and logistic regressions were used for birth size measurements and the odds of an infant being small in size for gestational age, respectively. Associations between combined metal mixtures and measurements at birth were evaluated using quantile g-computation and Bayesian kernel machine regression (BKMR).
Of the 103,060 JECS pregnancies, 93,739 mother-infant pairs were analyzed. The linear regression models showed that lead, selenium, cadmium, and manganese-but not mercury-were associated with body weight. Cadmium was associated with length and chest circumference and mercury was associated with head circumference. Quantile g-computation revealed that manganese increased infant birth weight, length, head circumference, and chest circumference. Lead was the strongest negative factor for infant birth weight, length, head circumference, and chest circumference. The BKMR analysis revealed that the metals had an additive, rather than a synergistic effect.
Metal exposure is associated with infant birth size, with lead and manganese playing a more significant role in Japan. The effects of prenatal combined metal exposure at low levels warrant public health attention.
胎儿期生长受限是一个重大的公共卫生问题。金属会对出生体重产生负面影响，而孕妇可能会接触到金属混合物。目前，使用个体和混合模型方法，对分析综合金属暴露与准确个体血液金属浓度对出生大小的影响的综合研究还很有限。本研究使用个体和混合模型方法，对来自日本一项大型全国性队列的孕妇的金属暴露与出生大小进行了研究。
在日本环境与儿童研究（JECS）中测量孕妇血液中的铅、镉、汞、硒和锰浓度。收集婴儿出生大小的测量值，包括体重、身长和头围、胸围。使用线性和逻辑回归分别对出生大小的测量值和婴儿出生时的小胎龄体重比的几率进行分析。使用分位数 g 计算和贝叶斯核机器回归（BKMR）评估混合金属混合物与出生时测量值之间的关系。
在 JECS 的 103060 例妊娠中，对 93739 对母婴进行了分析。线性回归模型显示，铅、硒、镉和锰与体重有关，但汞与体重无关。镉与身长和胸围有关，汞与头围有关。分位数 g 计算显示，锰增加了婴儿的出生体重、身长、头围和胸围。铅是婴儿出生体重、身长、头围和胸围的最强负因素。BKMR 分析显示，这些金属具有相加作用，而不是协同作用。
金属暴露与婴儿出生大小有关，在日本，铅和锰的作用更为显著。低水平的产前综合金属暴露的影响值得引起公共卫生关注。
