State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, Jiangsu, China.
State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
Sci Total Environ. 2024 Sep 10;942:173812. doi: 10.1016/j.scitotenv.2024.173812. Epub 2024 Jun 8.
Prenatal exposures to toxic metals and trace elements have been linked to childhood neurodevelopment. However, existing evidence remains inconclusive, and further research is needed to investigate the mixture effects of multiple metal exposures on childhood neurodevelopment. We aimed to examine the associations between prenatal exposure to specific metals and metal mixtures and neurodevelopment in children. In this prospective cohort study, we used the multivariable linear regressions and the robust modified Poisson regressions to explore the associations of prenatal exposure to 25 specific metals with neurodevelopment among children at 3 years of age in 854 mother-child pairs from the Jiangsu Birth Cohort (JBC) Study. The Bayesian kernel machine regression (BKMR) was employed to assess the joint effects of multiple metals on neurodevelopment. Prenatal manganese (Mn) exposure was negatively associated with the risk of non-optimal cognition development of children, while vanadium (V), copper (Cu), zinc (Zn), antimony (Sb), cerium (Ce) and uranium (U) exposures were positively associated with the risk of non-optimal gross motor development. BKMR identified an interaction effect between Sb and Ce on non-optimal gross motor development. Additionally, an element risk score (ERS), representing the mixture effect of multiple metal exposures including V, Cu, Zn, Sb, Ce and U was constructed based on weights from a Poisson regression model. Children with ERS in the highest tertile had higher probability of non-optimal gross motor development (RR = 2.37, 95 % CI: 1.15, 4.86) versus those at the lowest tertile. Notably, Sb [conditional-posterior inclusion probabilities (cPIP) = 0.511] and U (cPIP = 0.386) mainly contributed to the increased risk of non-optimal gross motor development. The findings highlight the importance of paying attention to the joint effects of multiple metals on children's neurodevelopment. The ERS score may serve as an indicator of comprehensive metal exposure risk for children's neurodevelopment.
产前暴露于有毒金属和微量元素与儿童神经发育有关。然而，现有证据仍不确定，需要进一步研究以调查多种金属暴露对儿童神经发育的混合效应。我们旨在研究产前暴露于特定金属和金属混合物与儿童神经发育之间的关系。在这项前瞻性队列研究中，我们使用多变量线性回归和稳健修正泊松回归来探讨 854 对母子的江苏出生队列（JBC）研究中，25 种特定金属的产前暴露与 3 岁儿童神经发育之间的关系。贝叶斯核机器回归（BKMR）用于评估多种金属对神经发育的联合效应。产前锰（Mn）暴露与儿童认知发育不良的风险呈负相关，而钒（V）、铜（Cu）、锌（Zn）、锑（Sb）、铈（Ce）和铀（U）暴露与儿童粗大运动发育不良的风险呈正相关。BKMR 确定了 Sb 和 Ce 之间对非最佳粗大运动发育的相互作用效应。此外，根据泊松回归模型的权重，构建了一个代表多种金属暴露混合物效应的元素风险评分（ERS），包括 V、Cu、Zn、Sb、Ce 和 U。ERS 最高 tertile 的儿童发生非最佳粗大运动发育的概率较高（RR=2.37，95%CI：1.15，4.86），而最低 tertile 的儿童则较低。值得注意的是，Sb[条件后验纳入概率（cPIP）=0.511]和 U（cPIP=0.386）主要导致非最佳粗大运动发育的风险增加。研究结果强调了关注多种金属对儿童神经发育的联合效应的重要性。ERS 评分可作为儿童神经发育综合金属暴露风险的指标。
