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Berky AJ, Weinhouse C, Vissoci J, Rivera N, Ortiz EJ, Navio S, Miranda JJ, Mallipudi A, Fixen E, Hsu-Kim H, Pan WK. In Utero Exposure to Metals and Birth Outcomes in an Artisanal and Small-Scale Gold Mining Birth Cohort in Madre de Dios, Peru. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:97008. [PMID: 37747404 PMCID: PMC10519195 DOI: 10.1289/ehp10557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Few birth cohorts in South America evaluate the joint effect of minerals and toxic metals on neonatal health. In Madre de Dios, Peru, mercury exposure is prevalent owing to artisanal gold mining, yet its effect on neonatal health is unknown. OBJECTIVES We aimed to determine whether toxic metals are associated with lower birth weight and shorter gestational age independently of antenatal care and other maternal well-being factors. METHODS Data are from the COhorte de NAcimiento de MAdre de Dios (CONAMAD) birth cohort, which enrolled pregnant women in Madre de Dios prior to their third trimester and obtained maternal and cord blood samples at birth. We use structural equation models (SEMs) to construct latent variables for the maternal metals environment (ME) and the fetal environment (FE) using concentrations of calcium, iron, selenium, zinc, magnesium, mercury, lead, and arsenic measured in maternal and cord blood, respectively. We then assessed the relationship between the latent variables ME and FE, toxic metals, prenatal visits, hypertension, and their effect on gestational age and birth weight. RESULTS Among 198 mothers successfully enrolled and followed at birth, 29% had blood mercury levels that exceeded the U.S. Centers for Disease Control and Prevention threshold of 5.8 μ g / L and 2 mothers surpassed the former 5 - μ g / dL threshold for blood lead. The current threshold value is 3.5 μ g / dL . Minerals and toxic metals loaded onto ME and FE latent variables. ME was associated with FE (β = 0.24; 95% CI: 0.05, 0.45). FE was associated with longer gestational age (β = 2.31; 95% CI: - 0.3 , 4.51) and heavier birth weight. Mercury exposure was not directly associated with health outcomes. A 1% increase in maternal blood lead shortened gestational age by 0.05 d (β = - 0.75 ; 95% CI: - 1.51 , - 0.13 ), which at the 5 - μ g / dL threshold resulted in a loss of 3.6 gestational days and 76.5 g in birth weight for newborns. Prenatal care visits were associated with improved birth outcomes, with a doubling of visits from 6 to 12 associated with 5.5 more gestational days (95% CI: 1.6, 9.4) and 319 g of birth weight (95% CI: 287.6, 350.7). DISCUSSION Maternal lead, even at low exposures, was associated with shorter gestation and lower birth weight. Studies that focus only on harmful exposures or nutrition may mischaracterize the dynamic maternal ME and FE. SEMs provide a framework to evaluate these complex relationships during pregnancy and reduce overcontrolling that can occur with linear regression. https://doi.org/10.1289/EHP10557.
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Affiliation(s)
- Axel J Berky
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Caren Weinhouse
- Oregon Institute of Occupational Health Sciences, Oregon Health & Sciences University, Portland, Oregon, USA
| | - Joao Vissoci
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Nelson Rivera
- Department of Civil and Environmental Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Ernesto J Ortiz
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Susy Navio
- Dirección Regional de Salud, Ministerio de Salud del Perú, Madre de Dios, Perú
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andres Mallipudi
- Bellevue Hospital Center/Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Emma Fixen
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Heileen Hsu-Kim
- Department of Civil and Environmental Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - William K Pan
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Cai FS, Tang B, Zheng J, Yan X, Luo WK, He M, Luo XJ, Ren MZ, Yu YJ, Mai BX. Fetal exposure to organic contaminants revealed by infant hair: A preliminary study in south China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120536. [PMID: 36367513 DOI: 10.1016/j.envpol.2022.120536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/16/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Fetal exposure to multiple organic contaminants (OCs) is a public concern because of the adverse effects of OCs on early life development. Infant hair has the potential to be used as an alternative matrix to identify susceptible fetuses, owing to its reliability, sensitivity, and advantages associated with sampling, handling, and ethics. However, the applicability of infant hair for assessing in utero exposure to OCs is still limited. In this study, 57 infant hair samples were collected in Guangzhou, South China, to evaluate the levels and compositions of typical OCs in the fetus. Most of the target OCs were detected in infant hair, with medians of 144 μg/g, 17.7 μg/g, 192 ng/g, 46.9 ng/g, and 1.36 ng/g for phthalate esters (PAEs), alternative plasticizers (APs), organophosphorus flame retardants (OPFRs), polybrominated diphenyl ethers (PBDEs), and organochlorine pesticides (OCPs), respectively. Meanwhile, paired maternal hair (0-9 cm from the scalp) was collected to examine the associations between maternal and infant hair for individual compounds. Low-brominated PBDEs tended to deposit in infant hair, with median concentrations approximately two times higher than those in maternal samples. Levels of PBDEs and 4,4'-dichlorodiphenyldichloroethylene (p,p'-DDE) in paired maternal and infant hair showed strong positive correlations (p < 0.05), while most plasticizers (PAEs and APs) were poorly correlated between paired hair samples. Exposure sources were responsible for the variation in correlation between OC levels in the paired infant and maternal samples. Crude relationships between fetal exposure to OCs and birth size were examined using the Bayesian kernel machine regression (BKMR) model. BDE-28 was found to be adversely associated with the birth size. This study provides referential information for evaluating in utero exposure to OCs and their health risks based on infant hair.
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Affiliation(s)
- Feng-Shan Cai
- State Key Laboratory of Organic Geochemistry, Guangdong Provincial Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, PR China; State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, PR China; University of Chinese Academy of Sciences, Beijing, 100049, PR China
| | - Bin Tang
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, PR China
| | - Jing Zheng
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, PR China; School of Public Health, Key Laboratory of Environmental Pollution and Disease Monitoring of Ministry of Education, Guizhou Medical University, Guiyang, 550000, PR China.
| | - Xiao Yan
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, PR China; School of Public Health, Key Laboratory of Environmental Pollution and Disease Monitoring of Ministry of Education, Guizhou Medical University, Guiyang, 550000, PR China
| | - Wei-Keng Luo
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, PR China
| | - Mian He
- Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518107, PR China
| | - Xiao-Jun Luo
- State Key Laboratory of Organic Geochemistry, Guangdong Provincial Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, PR China; Guangdong-Hong Kong-Macao Joint Laboratory for Environmental Pollution and Control, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, PR China
| | - Ming-Zhong Ren
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, PR China
| | - Yun-Jiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510655, PR China
| | - Bi-Xian Mai
- State Key Laboratory of Organic Geochemistry, Guangdong Provincial Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, PR China; Guangdong-Hong Kong-Macao Joint Laboratory for Environmental Pollution and Control, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, PR China
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