Impact of dietary mercury intake during pregnancy on the health of neonates and children: a systematic review

Fish intake and mercury exposure in young children

Fish consumption is one of the main sources of mercury (Hg) exposure, but few studies have examined Hg exposure from fish consumption among children. This study aimed to assess the frequency of fish intake and associations with Hg and other element concentrations among 700 three-year-old children from the New Hampshire Birth Cohort Study. Usual fish intake was derived from a validated food frequency questionnaire (Block Questionnaire for ages 2-7) and toenail element concentrations were determined using ICP-MS. Multiple linear regression analysis was used to assess the association between fish intake and toenail element concentrations. A mixture analysis, using Weighted quantile sum (WQS) regression, was used to estimate the relative contribution of fish consumption to element exposures. Twenty-three percent of children were reported to consume at least one fish meal/week on average during the previous 6 months. In adjusted linear regression models, children with any type of fish consumption versus no consumption had 108% (95% confidence interval (CI: 68%, 153%)) higher toenail Hg concentrations. To a lesser extent, children consuming "other fish (not fried) including tuna" and "fried fish or fish sticks" had 120% (95% CI: 82%, 164%), and 23% (95% CI: 2%, 51%) higher toenail concentrations, respectively, than those consuming no fish. Using WQS regression, Hg was the element most strongly related to fish consumption. Fish intake among young children was related to Hg exposure even at low levels of consumption. Future studies will need to determine the health consequences of this exposure.

Maternal diet quality during pregnancy and biomarkers of potentially toxic trace element exposure: Data from the ELFE cohort

The contribution of the diet to potentially toxic trace element exposure in pregnancy has been rarely addressed. The objective of the present study was to determine the association between the maternal diet during pregnancy and biomarkers of exposure for arsenic (As), mercury (Hg) and lead (Pb) at delivery. As was assessed in maternal urine, Hg in maternal hair, and Pb in cord blood, as a proxy for in utero exposure. Based on 2995 women from the ELFE nationwide birth cohort, higher scores for dietary patterns considered healthy were associated with higher concentrations of As and Hg in maternal matrices. Levels of cord blood Pb were inconsistently associated with dietary patterns considered healthy, and lower with a dietary pattern driven by milk and breakfast cereals. Lower levels of Hg were associated with higher Western dietary pattern scores. In conclusion, higher levels of maternal urinary As and hair Hg are associated with diets considered as "Healthy", while cord blood Pb was not strongly correlated with dietary exposure.

Mercury exposure in the Norwegian Mother, Father, and Child Cohort Study - measured and predicted blood concentrations and associations with birth weight

Background

Blood total mercury concentration (BTHg) predominantly contains methyl Hg from seafood, and less inorganic Hg. Measured BTHg is often available only in a small proportion of large cohort study samples. Associations between estimated dietary intake of total Hg (THg) and lower birth weight within strata of maternal seafood intake was previously reported in the Norwegian Mother, Father, and Child Cohort Study (MoBa). However, maternal seafood consumption was associated with increased birth weight, indicating negative confounding by seafood in the association between THg intake and birth weight. Using predicted BTHg as a proxy for measured BTHg, we hypothesized that predicted BTHg would be associated with decreased birth weight.

Objectives

To develop and validate a prediction model for BTHg in MoBa and to examine the association between predicted BTHg and birth weight in the MoBa population.

Methods

Using linear regression, measured maternal BTHg (n = 1437) was used to build the best fitting model (highest R-squared value). Model validation (n = 1436) was based on correlation and weighted Kappa (Кw). Associations between predicted BTHg in the MoBa population (n = 86,775) or measured BTHg (n = 3590) and birth weight were assessed by multivariate linear regression models.

Results

The best fitting model had R-squared = 0.3 and showed strong correlation (r = 0.53, p < 0.001) between predicted and measured BTHg. Cross-classification (quintiles) showed 73 % correctly classified and 3.3 % grossly misclassified, with Кw of 0.37. Measured BTHg was not associated with birth weight. Predicted BTHg was significantly associated with higher birth weight. There were no trends in birth weight with increasing quintiles of measured or predicted BTHg after stratification into high or low seafood consumption.

Conclusions

The results indicate that prediction of BTHg did not overcome negative confounding of the association between Hg exposure and birth weight by seafood intake. Furthermore, effect on birth weight of toxicological concern is unexpected in our observed BTHg range.

A high-throughput, straightforward procedure for biomonitoring organomercury species in human hair

Mercury is a pervasive and concerning pollutant due to its toxicity, mobility, and tendency to biomagnify in aquatic and terrestrial ecosystems. Speciation analysis is crucial to assess exposure and risks associated with mercury, as different mercury species exhibit varying properties and toxicities. This study aimed at developing a selective detection method for organic mercury species in a non-invasive biomonitoring matrix like human hair. The method is based on frontal chromatography (FC) in combination with inductively coupled plasma mass spectrometry (ICP-MS), using a low pressure, homemade, anion exchange column inserted in a standard ICP-MS introduction system, without requiring high-performance liquid chromatography (HPLC) hyphenation. In addition to the extreme simplification and cost reduction of the chromatographic equipment, the proposed protocol involves a fast, streamlined and fully integrated sample preparation process (in contrast to existing methods): the optimized procedure features a 15-min ultrasonic assisted extraction procedure and 5 min analysis time. Consequently, up to 100 samples could be analyzed daily, making the method highly productive and suitable for large-scale screening programs in public and environmental health. Moreover, the optimized procedure enables a limit of detection (LOD) of 5.5 μg/kg for a 10 mg hair microsample. All these features undeniably demonstrate a significant advancement in routine biomonitoring practices. To provide additional evidence, the method was applied to forty-nine human hair samples from individuals with varying dietary habits successfully finding a clear correlation between methylmercury levels (ranging from 0.02 to 3.2 mg/kg) in hair and fish consumption, in line with previous literature data.

Selenium-rich food potentially useful to control mercury levels among Afro-Colombians: Towards an intercultural intervention

INTRODUCTION

Diet-based interventions may be a culturally acceptable option to decrease mercury levels and thus prevent the adverse effects of this metal on population health. Selenium is an element present in Colombian geology that can act as a chelator, decreasing mercury concentrations in the human body.

OBJECTIVE

To identify potentially useful selenium-rich foods to control the effects of mercury exposure among Afro-Colombians.

MATERIALS AND METHODS

A cross-sectional study was carried out with 320 individuals from five municipalities of Chocó. They were asked about the frequency of consumption of selenium-rich foods, and their association with mercury concentrations in hair was estimated with multiple robust regression.

RESULTS

Guava, whole wheat flour, strawberries, cow liver, spinach and yeast extract were the foods with higher consumption. Walnuts, whole wheat flour, and yeast extract were identified in multiple robust regression as foods to consider in future interventions.

CONCLUSION

It is proposed that the banana juice, the pineapple colada, the borojó (Borojoa patinoi) sorbet, the cucas, and the enyucado are basic elements for a culturally acceptable intervention.

The effectiveness of an intervention to reduce exposure to trace metals during or prior to pregnancy: A prospective study in urban and rural locations

Background

Prenatal exposure to trace metals can have adverse effects on health and increase the risk of developing certain diseases. This study aimed to determine the effectiveness of giving women advice to reduce their exposure to trace metals during pregnancy or prior to conception. The study also examined differences in exposure between rural and urban environments in southern France.

Methods

In this prospective study, pregnant women or those intending to conceive were recruited from two medical centers for gynecology/obstetrics (rural location: Saint-Rémy-de-Provence; urban location: Marseille). Hair samples were collected and analyzed to determine the levels of exposure to trace metals. Participants with 'risky' levels were given corresponding advice sheets on how to reduce their exposure or, for certain metals, they were encouraged to find out about potential sources of exposure. A second hair sample was collected and analyzed 3 months later.

Results

It was found that 109 women had 'risky' levels of exposure to trace metals, out of a total of 184 women (59.2 %). Cerium was the most frequently identified metal (N = 26), followed by nickel (N = 23), and titanium (N = 19). There were more women at the urban center with 'risky' levels (56/86; 65.1 %) than at the rural center (53/98; 54.1 %), but this difference was not statistically significant (p = 0.13). Advice sheets were given to 64 of the 109 participants with 'risky' levels (58.7 %), but only 21 returned for the second hair analysis. Of these, 14 were found to have reduced their exposure, which corresponds to just 12.8 % (14/109) of the participants with 'risky' levels.

Conclusions

These results indicate that it would be helpful to develop new interventions to reduce trace metal exposure during or prior to pregnancy.

Fish intake in pregnant women and its impact on maternal-fetal health status

OBJECTIVE

The objective was to evaluate the consumption of fish in pregnant women and its association with maternal and infant outcomes.

MATERIAL AND METHODS

In this observational study carried out at the La Fe University and Polytechnic Hospital in Valencia, 300 pregnant women participated. The participants were divided into 2 groups according to their fish consumption during pregnancy for comparison. The χ2 test or ANOVA test were applied for comparisons for qualitative and quantitative variables respectively.

RESULTS

It was observed that 49% of women consumed adequate amounts of fish during pregnancy (2 or 3 weekly servings). Significant differences were observed for iron supplementation (higher in women with inadequate fish consumption), threatened pregnancy loss (higher in women with inadequate fish consumption), infant size (better in women with adequate fish consumption), and arterial O2 pressure (better in women with adequate fish consumption). In regard to the other components of the dietary pattern, no differences were observed but the adequacy of intake for grains and white meat was very poor (less than 5.0%).

CONCLUSIONS

Half of the women met the recommendations for fish intake during pregnancy and presented an overall healthier eating pattern but without statistical significance.

Significance of Intestinal Helminth Infection and Animal Sex for Mercury Concentrations in Two Rodent Species

We compared the effects of animal gender, species, and intestinal helminth burden on mercury concentrations in rodents. Total mercury concentrations were determined in the liver and kidney tissues of 80 small rodents (44 yellow-necked mice, Apodemus flavicollis, and 36 bank voles, Myodes glareolus) captured in the Ore Mountains (northwest Bohemia, Czech Republic). Overall, 25/80 (32%) of animals were infected by intestinal helminths. The differences in mercury concentration between rodents infected and not infected with intestinal helminths were not statistically significant. Statistically significant differences in mercury concentrations were found only between voles and mice (that were not infected with intestinal helminths). This suggests the differences may be associated with host genetics. Apodemus flavicollis body tissues had significantly lower (P=0.01) mean Hg concentrations (0.032 mg/kg) than Myodes glareolus (0.279 mg/kg), provided that animals were not infected by intestinal helminths; if the animals were infected by intestinal helminths, the difference between both groups was insignificant. The effect of gender in this study was significant only for voles (without helminth infection); for mice (either with or without helminth infection) the differences between genders were not significant. Myodes glareolus males had significantly lower (P=0.03) Hg concentrations in liver and kidney tissues (0.050 mg/kg) than Myodes glareolus females (0.122 mg/kg). These results reveal the importance of considering species and gender when evaluating mercury concentrations.

Periconceptional diet quality and its relation to blood heavy metal concentrations among pregnant women: The Japan environment and Children's study

BACKGROUND

Diets contain toxic chemical contaminants as well as essential nutrients, both of which influence the intrauterine environment for foetal growth. However, whether a high-quality diet that is nutritionally healthy also results in lower exposure to chemical contaminants is unknown.

OBJECTIVE

We examined associations between periconceptional maternal diet quality and circulating concentrations of heavy metals during pregnancy.

DESIGN

Dietary intake over the year prior to the first trimester of pregnancy was assessed using a validated, self-administered food frequency questionnaire among 81,104 pregnant Japanese women who participated in the Japan Environment and Children's Study. Overall diet quality was determined using the Balanced Diet Score (BDS) based on the Japanese Food Guide Spinning Top, the Healthy Eating Index-2015 (HEI-2015), the Dietary Approaches to Stop Hypertension (DASH) score and the Mediterranean diet score (MDS). We measured whole-blood concentrations of mercury (Hg), lead (Pb) and cadmium (Cd) during the second or third trimester of pregnancy.

RESULTS

After controlling for confounders, all diet quality scores were positively associated with blood Hg concentrations. By contrast, higher BDS, HEI-2015 and DASH scores were associated with lower concentrations of Pb and Cd. Although the MDS was positively associated with concentrations of Pb and Cd, when dairy products were classified as a beneficial (rather than detrimental) food component, these associations were attenuated.

CONCLUSION

A high-quality diet may reduce exposure to Pb and Cd but not Hg. Further studies are required to determine the optimal balance between mercury exposure risk and nutritional benefits of high-quality diets prior to pregnancy.

Periconceptional maternal diet quality influences blood heavy metal concentrations and their effect on low birth weight: the Japan Environment and Children's Study

BACKGROUND

Both poor maternal nutrition and toxic heavy metal exposure influence foetal growth and development. However, whether consumption of a variety of healthy foods modifies the association between prenatal heavy metal exposure and foetal growth is unknown.

OBJECTIVE

We examined whether long-term maternal diet quality in periconception modifies the associations between maternal circulating concentrations of heavy metals and foetal growth.

DESIGN

Data of 72,317 Japanese women who delivered singleton infants was extracted from the Japan Environment and Children's Study. Maternal diet over a 1-year before the first trimester of pregnancy was assessed using a validated food frequency questionnaire, and overall diet quality was determined using the balanced diet score based on the Japanese Food Guide Spinning Top. Maternal whole-blood concentrations of mercury (Hg), lead (Pb) and cadmium (Cd) were measured during the second/third trimester of pregnancy. Bayesian inference of multiple linear regression analysis was performed to evaluate the relationships between maternal diet quality and the blood concentrations of heavy metals; Bayesian logistic regression was used to analyse the risk of low birth weight (LBW; <2,500 g).

RESULTS

After controlling for confounders, a high maternal balanced diet score was associated with low concentrations of blood Pb and Cd and high Hg. While all heavy metals assessed were positively associated with LBW risk, a higher maternal balanced diet score was negatively associated with LBW risk. A high-quality maternal diet attenuated the effect of Pb on LBW, an effect that was more marked at high blood Pb concentrations.

CONCLUSION

A high-quality, 'well-balanced' diet prior to conception may reduce exposure to some heavy metals and mitigate the elevated risk of LBW associated with prenatal Pb exposure in Japanese mother-child pairs.

Occupational and environmental mercury exposure and human reproductive health - a review

Mercury is a toxic heavy metal. Humans are exposed to mercury through several sources including environmental, occupational, contaminated food and water and from mercury-containing dental amalgam. Mercury exposure is known to harm the nervous system profoundly, and have a negative impact on digestive and immune systems, and other organs. To review and discuss the effect of mercury exposure through environmental or occupational routes on human reproduction, pregnancy, and its outcome. Published information about the potential toxic effects of mercury on human reproduction were collected and summarized. Literature was identified by systematic search using relevant keywords. Literature review revealed a number of negative impacts of mercury on human reproduction. These included effects on semen quality, including reduced sperm count, motility, and changes in morphology that may reduce fertility potential. There may also be an effect in changing reproductive hormone levels. Mercury exposure might also affect pregnancy but the data concerning mercury effects on female reproduction are limited except for some data about mercury exposure and poor pregnancy outcomes. Available data indicate that mercury exposure may have a toxicity effect on reproductive potential, especially in males. Prenatal mercury exposure may affect pregnancy or its outcome and this appears to be dependent upon dose, duration, and timing of exposure. Nutritional status of exposed individual might also influence the impact of mercury.

Prenatal Mercury Exposure and Neurodevelopment up to the Age of 5 Years: A Systematic Review

Neurodevelopmental delays can interfere with children’s engagement with the world and further development, and may have negative consequences into adulthood. Mercury is highly toxic and may negatively influence neurodevelopment because it can freely cross the placenta and accumulate in the fetal brain. We searched four publication databases (Embase, PsycINFO, PubMed/MEDLINE, Scopus) for studies examining the relationship between early life mercury exposure and scores on neurodevelopmental performance measures in children aged 0 to 5 years old. Study quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool. Thirty-two prospective studies were included in the review. Neurodevelopmental performance was measured using 23 different scales, most commonly the Bayley Scales of Infant and Toddler Development (BSID). In most cases, the evidence for an association between mercury and neurodevelopment was weak. There did not appear to be exceptions for particular childhood ages, outcome scales, or mercury levels. The small number of results to the contrary were more likely to be studies which did not meet our high-quality criteria, and could be a consequence of multiple testing, selection bias, or incomplete confounder adjustment. Based on current evidence, dietary mercury exposure during pregnancy is unlikely to be a risk factor for low neurodevelopmental functioning in early childhood.