Li Zhen-Hua, Hu Cheng-Yang, Dai Si-Wei, Ma Hui-Ya, Zhang Si-Yu, Sun Chen, Li Jia-Hui, Huang Kai, Chen Mao-Lin, Gao Guo-Peng, Zhang Xiu-Jun
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
Sci Total Environ. 2025 Jan 10;959:178291. doi: 10.1016/j.scitotenv.2024.178291. Epub 2024 Dec 29.
The associations of prenatal metals exposure with birth outcomes have been widely assessed. However, evidence on the associations between metal mixtures and fetal intrauterine growth trajectories is scarce.
This study aimed to explore the associations of metal mixtures with fetal intrauterine growth trajectories overall and by sex.
We analyzed data from the Ma'anshan birth cohort, which included a total of 1041 pregnant woman. The concentrations of 12 metals in maternal blood were measured during early pregnancy, and fetal intrauterine growth indicators were standardized and assessed at 16, 23, 30, 34, and 38 weeks of gestation. We used generalized linear regression and linear mixed models to identify the key fetal growth indicator (biparietal diameter (BPD)), and applied GBTM to characterize BPD SD-scores trajectories. To further assess the individual and combined effects of metals, we conducted multivariable logistic regression and repeated holdouts weighted quantile sum (WQS) regression analyses, respectively. Finally, we performed a sex-stratified analysis to explore sex-specific associations.
The sex-stratified multivariable logistic regression analysis indicated that in male fetal, cobalt (Co) (OR: 0.60, 95 % CI: 0.38, 0.92) was negatively associated with the high-growth BPD-SD scores trajectory. In contrast, Co (OR: 2.39, 95 % CI: 1.40, 4.45) showed a positive association in female fetal. Results from the WQS showed that early pregnancy metal mixture exposure was associated with BPD-SD scores at 16, 34, and 38 weeks in female fetal. The results highlighted Zn and Co as key metals associated with high-growth BPD SD-scores trajectory. We also identified a significant interaction between early pregnancy metal mixtures and sex on high-growth BPD SD-scores trajectories. The WQS*sex interaction term had a mean odds ratio of 1.271 (95 % CI: 1.027, 1.619).
This study suggests that exposure to prenatal metal mixtures affects fetal intrauterine growth trajectories with sexual dimorphism.
产前金属暴露与出生结局之间的关联已得到广泛评估。然而，关于金属混合物与胎儿宫内生长轨迹之间关联的证据却很稀少。
本研究旨在探讨金属混合物与胎儿整体宫内生长轨迹以及按性别划分的宫内生长轨迹之间的关联。
我们分析了马鞍山出生队列的数据，该队列共有1041名孕妇。在孕早期测量孕妇血液中12种金属的浓度，并在妊娠16、23、30、34和38周时对胎儿宫内生长指标进行标准化和评估。我们使用广义线性回归和线性混合模型来确定关键的胎儿生长指标（双顶径（BPD）），并应用广义加性模型（GBTM）来描述BPD标准差分数轨迹。为了进一步评估金属的个体和联合效应，我们分别进行了多变量逻辑回归和重复留出加权分位数和（WQS）回归分析。最后，我们进行了性别分层分析以探索性别特异性关联。
性别分层的多变量逻辑回归分析表明，在男性胎儿中，钴（Co）（比值比：0.60，95%置信区间：0.38，0.92）与高生长BPD标准差分数轨迹呈负相关。相比之下，Co（比值比：2.39，95%置信区间：1.40，4.45）在女性胎儿中呈正相关。WQS的结果表明，孕早期金属混合物暴露与女性胎儿在16、34和38周时的BPD标准差分数相关。结果突出了锌和钴作为与高生长BPD标准差分数轨迹相关的关键金属。我们还确定了孕早期金属混合物与性别在高生长BPD标准差分数轨迹上存在显著交互作用。WQS*性别交互项的平均比值比为1.271（95%置信区间：1.027，1.619）。
本研究表明，产前金属混合物暴露会影响具有性别差异的胎儿宫内生长轨迹。
