Cord Blood Methylmercury and Fetal Growth Outcomes in Baltimore Newborns: Potential Confounding and Effect Modification by Omega-3 Fatty Acids, Selenium, and Sex

The association between mercury exposure during pregnancy and adverse birth outcomes: A systematic review and meta-analysis

Studies have shown that mercury (Hg) exposure during pregnancy is associated with adverse birth outcomes (ABO) in infants, but the association between the two has not been systematically summarized. Therefore, we conducted a systematic review and meta-analysis of existing observational studies on the association between maternal Hg exposure (MHE) during pregnancy and ABO in infants to evaluate the association between them. We comprehensively searched all relevant literature published in three electronic databases (Web of Science, PubMed, Embase) from 2004 to June 2024. According to the heterogeneity, fixed effect model (I2 ≤ 50 %) or random effect model (I2 > 50 %) was used to pool the associated effect values. The results showed a positive association between MHE and low birth weight (LBW) (OR = 1.079, 95 % CI: 1.032-1.128) and no statistically significant association between and preterm birth (PTB) (OR = 1.044, 95 % CI: 0.956-1.140) and small-for-gestational-age (SGA) (OR = 1.006, 95 % CI: 0.983-1.030). In addition, each 10-fold increase in MHE during pregnancy was associated with abnormal Birth Anthropometrics. These findings suggest that MHE is a risk factor for LBW and is associated with abnormal anthropometric measurements at birth. However, there is insufficient evidence for Hg exposure and SGA, PTB. Further population-based studies are warranted to investigate these associations.

Prenatal exposure to metal mixtures, body mass index trajectories in early life and effect modifiers: Insights from a prospective birth cohort study

Current scientific knowledge is insufficient on the effects of metal mixtures on early life growth trajectories. This study included 7118 mother-infant pairs from a Chinese birth cohort. Concentrations of 18 maternal urinary metals were quantified, and growth trajectories were conducted based on standardized body mass index (BMI) for up to eight times from 0 to 2 years. A three-phase analytical framework was applied to explore the risk ratios (RR) and 95 % confidence intervals (95 % CI) of co-exposure to metals on dynamic growth, along with potential modifiers. Five growth trajectory groups were identified. Exposure to metal mixtures driven by thallium (Tl, 34.8 %) and aluminum (Al, 16.2 %) was associated with an increased risk of low-rising trajectory (RR=1.58, 95 % CI: 1.25, 2.00); however, exposure to mixtures driven by strontium (Sr, 49.5 %) exhibited an inverse correlation (RR = 0.81, 95 % CI: 0.67, 0.97). Furthermore, infants with varying levels of Tl, Al and Sr, as well as modifiers including pre-pregnancy BMI and infant sex faced distinct risks of low-rising trajectory. Our findings highlighted the Tl, Al, and Sr as key metals in relation to the low-rising trajectory in early life characterized as catch-up growth, with pre-pregnancy BMI and infant sex exerting as potential modifiers.

Trimester-specific prenatal heavy metal exposures and sex-specific postpartum size and growth

BACKGROUND

There has been limited research considering the effects of prenatal exposure to multiple heavy metals on early childhood size and growth.

OBJECTIVE

We evaluated prenatal exposures to 15 heavy metals in association with measures of weight, length, and head circumference (HC) measured at birth, and 1, 3 and 6 months of age in a study of 358 mother-child pairs.

METHODS

Urinary concentrations were measured in the first and third trimesters of pregnancy and examined, using sex-stratified general linear models, in association with average standardized size and changes in size (growth) over the first 6 months of life. Confounding effects among metals were explored.

RESULTS

Increased first trimester Hg and V were associated with decreased average HC among males and weight among females, respectively. Increased first trimester V was associated with a decline in weight among females over time. Increased third trimester Cs, Rb and Tl were associated with increased average weight and HC among males. Increased third trimester Se was associated with increased HC among females over time. Evidence for confounding was observed between Cs, Rb and Tl in association with weight and HC.

SIGNIFICANCE

We observed multiple biologically plausible associations between prenatal heavy metal exposures and postnatal size and growth.

IMPACT

We have taken a comprehensive and novel approach to evaluating the impacts of prenatal heavy metal exposures on size and growth during early childhood. Our detailed analyses consider exposures to 15 different heavy metals at two time points during pregnancy, as well as multiple metrics of size and growth collected at birth and 1, 3 and 6 months of age.

In Utero Exposure to Metals and Birth Outcomes in an Artisanal and Small-Scale Gold Mining Birth Cohort in Madre de Dios, Peru

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.

Maternal Metals Exposure and Infant Weight Trajectory: The Japan Environment and Children's Study (JECS)

BACKGROUND

To our knowledge, the association of maternal exposure to metallic elements with weight trajectory pattern from the neonatal period has not been investigated.

OBJECTIVES

The goals of this study were to identify infant growth trajectories in weight in the first 3 y of life and to determine the associations of maternal blood levels of lead, cadmium, mercury, selenium, and manganese with growth trajectory.

METHODS

This longitudinal study, part of the Japan Environment and Children Study, enrolled 103,099 pregnant women at 15 Regional Centres across Japan between 2011 and 2014. Lead, cadmium, mercury, selenium, and manganese levels were measured in blood samples collected in the second (14-27 wk gestational age) or third trimester (≥28wk). Growth trajectory of 99,014 children was followed until age 3 y. Raw weight values were transformed to age- and sex-specific weight standard deviation (SD) scores, and latent-class group-based trajectory models were estimated to determine weight trajectories. Associations between maternal metallic element levels and weight trajectory were examined using multinomial logistic regression models after confounder adjustment.

RESULTS

We identified 5 trajectory patterns based on weight SD score: 4.74% of infants were classified in Group I, very small to small; 31.26% in Group II, moderately small; 21.91% in Group III, moderately small to moderately large; 28.06% in Group IV, moderately large to normal; and 14.03% in Group V, moderately large to large. On multinomial logistic regression, higher maternal lead and selenium levels tended to be associated with increased odds ratios (ORs) of poor weight SD score trajectories (Groups I and II), in comparison with Group III. Higher levels of mercury were associated with decreased ORs, whereas higher levels of manganese were associated with increased ORs of "moderately large" trajectories (Groups IV and V).

DISCUSSION

Maternal lead, mercury, selenium, and manganese blood levels affect infant growth trajectory pattern in the first 3 y of life. https://doi.org/10.1289/EHP10321.

Population attributable fraction of risk factors for low birth weight in the Japan Environment and Children's Study

BACKGROUND

Low birth weight (LBW), which is considered a birth weight of <2500  g, poses significant health problems for children. However, population attributable fraction (PAF) of risk factors for LBW have not been well studied.

OBJECTIVE

We aimed to re-evaluate associations between risk factors for LBW reported in previous studies that used the Japan Environment and Children's Study (JECS) data, and to estimate the magnitude of risk using PAF.

METHODS

Data including 91,559 mother-child dyads were obtained from JECS. Risk factors identified by previous studies that used JECS data were used to calculate odds ratios for LBW using a Bayesian logistic regression model. Based on calculated odds ratios, the PAF was calculated.

RESULTS

Parity, history of adenomyosis, hypertension disorder of pregnancy, maternal age at birth, prepregnancy body mass index, gestational weight gain (GWG), maternal smoking and lead (Pb) exposure were all significantly associated with LBW. The sum of the PAF of all factors was 79.4 %, with the largest PAF among single risk factors being GWG (16.5 %); the environmental portion of the PAF (Pb exposure, 14.6 % + maternal smoking, 12.1 %) surpassed the PAF of GWG.

CONCLUSION

Our findings suggest that the number of births classified as LBW can be reduced by approximately 27% if Pb exposure is reduced to the lowest quartile and maternal smoking is eliminated. Further investigations are needed to identify unknown risk factors for LBW.

Heavy metal blood concentrations in association with sociocultural characteristics, anthropometry and anemia among Kenyan adolescents

OBJECTIVES

To measure heavy metal concentrations among Kenyan youth and quantify associations with sociocultural, demographic, and health factors as well as anthropometry.

METHODS

Using data from a study of semi-nomadic pastoralists in Samburu County, Kenya, we measured blood concentrations of lead (Pb), mercury (Hg), and cadmium (Cd) in 161 adolescents. We identified sociocultural, demographic and health characteristics associated with each metal and quantified the association between metals and adolescent anthropometry.

RESULTS

Median blood concentrations of Pb, Cd, and Hg were 1.82 µg/dL, 0.24 µg/L and 0.16 µg/L, respectively. Place of residence (highlands vs lowlands) was a determinant of metal concentrations. Hg was inversely related to anemia, and metals were not associated with anthropometry.

CONCLUSIONS

In this population of Samburu adolescents, median Pb and Cd blood concentrations were higher than other North American or European biomonitoring studies. These findings motivate further investigation into the environmental sources of metals in this community.

Positive association between dietary exposure to polybrominated diphenyl ethers and breast cancer risk in the French E3N cohort: The role of vegetable oil consumption

Exposure to endocrine-disrupting chemicals, like Polybrominated diphenyl ethers (PBDEs), is suspected of playing a role in the occurrence of breast cancer. Moreover, there is growing evidence that food chemical contaminants, especially lipophilic ones such as PBDEs, could interact with different components of the diet. The objective of the present study was to assess the association between dietary intake of PBDEs and breast cancer risk in the French E3N cohort study, and to investigate the potential modification of this association by vegetable oil consumption. The study included 67879 women. Intakes of eight PBDEs were estimated using food consumption data from a validated semi-quantitative food frequency questionnaire, and food contamination levels measured by the French Agency for Food, Environmental and Occupational Health and Safety (ANSES). Cox proportional hazards models were used to estimate Hazard Ratios (HR) and 95% Confidence Intervals (CI) for the association between total PBDEs dietary intake and breast cancer risk. Interaction measures for vegetable oil consumption were estimated on both additive and multiplicative scales. The women were followed for a maximum of 21.4 years, and 5 686 developed an incident breast cancer. A positive linear trend was highlighted between dietary intake of PBDEs in quintile groups and breast cancer risk, borderline with statistical significance (p-trend = 0.06, HR_Q5vsQ1 and 95% CI: 1.09 [0.99;1.20]). Interaction measures for vegetable oil consumption were significant in both additive and multiplicative scales. Higher effect sizes of the association were highlighted in high consumers of vegetable oil, i.e. ≥4.6 g/day (HR_Q5vsQ1 and 95% CI: 1.23 [1.08; 1.40]), and almost no effect were found in low consumers (HR_Q5vsQ1 and 95% CI: 0.97 [0.86; 1.10]). Highlighting such interactions between nutrients and chemicals is crucial to develop efficient dietary recommendations to limit the negative health effects associated with exposure to food chemical contaminants.

The First Exposure Assessment of Mercury Levels in Hair among Pregnant Women and Its Effects on Birth Weight and Length in Semarang, Central Java, Indonesia

(1) Background: Methylmercury (MeHg) exposure during pregnancy is an important issue due to its possible adverse health effects on fetus. To contribute the development of assessment system of Hg exposure through fish consumption and health effects on children, we examined the hair Hg levels in pregnant women and birth weight and length. (2) Methods: In 2018, a cohort study was conducted on 118 pregnant women-infant pairs from six community health centers in the northern coastal area in Central Java Indonesia. Data on mothers' characteristics during pregnancy, birth outcomes, and fish consumption were collected. Total Hg concentrations were determined from hair samples. (3) Results: The median (min-max) of the maternal hair Hg level was 0.434 (0.146-8.105) µg/g. Pregnant women living in lowland areas, near the sea, showed higher hair Hg concentration and fish consumption than those in highland areas {[0.465 (0.146-8.105) vs. 0.385 (0.150-1.956) µg/g; p = 0.043] and [(85.71 (0-500.0) vs. 49.76 (0.0-428.57) g/day; p < 0.01], respectively}. The maternal hair Hg level had no association with baby's birth weight and length. (4) Conclusions: The median maternal hair Hg is at a low level and had no association with infant birth weight and length in this study subjects.

Free Cortisol Mediates Associations of Maternal Urinary Heavy Metals with Neonatal Anthropometric Measures: A Cross-Sectional Study

Prenatal exposure to heavy metals is known to be associated with adverse birth outcomes and oxidative stress biomarkers. In this study, we examined whether maternal free cortisol or 8-Hydroxy-2-Deoxyguanosine (8-OHdG) could mediate associations between maternal heavy metal exposure and birth outcomes. A total of 182 healthy pregnant women were recruited. Heavy metals (including Pb, Hg, and Cd), free-cortisol, and 8-OHdG were analyzed in urine at delivery. Birth outcomes including birth weight, length, Ponderal index, and head circumference were measured. To examine associations of maternal urinary heavy metals with biomarkers and birth outcomes, generalized linear models were employed. Birth length was positively associated with Pb (β = 0.78, 95% CI: 0.09−1.46) and Hg (β = 0.84, 95% CI: 0.23−1.45) (both p < 0.05). The Ponderal index, a measure of a newborn’s leanness, was negatively associated with maternal urinary Pb (β = −0.23, 95% CI: −0.46−−0.07) and Hg (β = −0.26, 95% CI: −0.44−−0.08) (both p < 0.05). No association between maternal Cd and birth outcomes was observed. Most heavy metals showed positive associations with free cortisol and 8-OHdG. Free cortisol was identified as a mediator underlying the observed relationship between Hg and birth length or Ponderal index. This study observed adverse birth outcomes from maternal exposures to Pb and Hg. Increased free cortisol related to Hg exposure was suggested as a possible causal pathway from Hg exposure to birth outcomes such as the Ponderal index.

Impact of selenium on cerebellar injury and mRNA expression in offspring of rat exposed to methylmercury

During the fetal development stage, the Central Nervous System (CNS) is particularly sensitive to methylmercury (MeHg). However, the mechanism underlying the antagonistic effect of selenium (Se) on MeHg toxicity is still not fully understood. In this study, female rat models with MeHg and Se co-exposure were developed. Pathological changes in the cerebellum and differential mRNA expression profiles in offspring rats were studied. In the MeHg-exposed group, a large number of Purkinje cells showed pathological changes and mitochondria were significantly swollen; co-exposure with Se significantly improved the structure and organization of the cerebellum. In total, 378 differentially expressed genes (DEGs) (including 284 up-regulated genes and 94 down-regulated genes) in the cerebellum of the MeHg-exposed group and 210 DEGs (including 84 up-regulated genes and 126 down-regulated genes) in the cerebellum of the MeHg+Se co-exposed group were identified. The genes involved in neurotransmitter synthesis and release and calcium ion balance in the cerebellum were significantly up-regulated in the MeHg-exposed group. These genes in the MeHg+Se co-exposed group were not changed or down-regulated. These findings demonstrate that the neurotoxicity caused by MeHg exposure is related to the up-regulation of multiple genes in the nerve signal transduction and calcium ion signal pathways, which are closely related to impairments in cell apoptosis and learning and memory. Supplementation with Se can mitigate the changes to related genes and protect neurons in the mammalian brain (especially the developing cerebellum) from MeHg toxicity. Se provides a potential intervention strategy for MeHg toxicity.

Mercury and Prenatal Growth: A Systematic Review

The intrauterine environment is critical for healthy prenatal growth and affects neonatal survival and later health. Mercury is a toxic metal which can freely cross the placenta and disrupt a wide range of cellular processes. Many observational studies have investigated mercury exposure and prenatal growth, but no prior review has synthesised this evidence. Four relevant publication databases (Embase, MEDLINE/PubMed, PsycINFO, and Scopus) were systematically searched to identify studies of prenatal mercury exposure and birth weight, birth length, or head circumference. Study quality was assessed using the NIH Quality Assessment Tool, and results synthesised in a narrative review. Twenty-seven studies met the review criteria, these were in 17 countries and used 8 types of mercury biomarker. Studies of birth weight (total = 27) involving populations with high levels of mercury exposure, non-linear methods, or identified as high quality were more likely to report an association with mercury, but overall results were inconsistent. Most studies reported no strong evidence of association between mercury and birth length (n = 14) or head circumference (n = 14). Overall, our review did not identify strong evidence that mercury exposure leads to impaired prenatal growth, although there was some evidence of a negative association of mercury with birth weight.

Prenatal exposure to multiple metals and birth outcomes: An observational study within the National Children's Study cohort

BACKGROUND

Prenatal exposure to metals may play an important role in fetal growth. However, the epidemiologic evidence for certain metals is sparse, and most of the existing research has focused on evaluating single metals in highly exposed target populations.

OBJECTIVES

We evaluated associations of cadmium, lead, manganese, selenium, and total mercury exposures during pregnancy with fetal growth using data from mother-infant pairs participating in the National Children's Study.

METHODS

Prenatal metal exposures were measured using maternal blood collected from 6 to 32 weeks of gestation. Birth outcomes, including gestational age, birthweight, birth length, head circumference, and ponderal index, were ascertained through physical measurement at birth or abstraction from medical records. Regression coefficients and their 95% confidence intervals were estimated from multivariable linear regression models in the overall study population as well as among male and female infants. We further evaluated pairwise metal-metal interactions.

RESULTS

Sex-specific associations were observed for lead, with inverse associations for birthweight, birth length, head circumference, and gestational age observed only among female infants. Sex-specific associations were also observed for selenium, with a positive association for birthweight observed among male infants; selenium was also positively associated with ponderal index and inversely associated with birth length among female infants. Overall, total mercury was inversely associated with birthweight and ponderal index, and the association with birthweight was stronger among female infants. No significant associations were observed with cadmium and manganese. In the metal-metal interaction analyses, we found evidence of a synergistic interaction between lead and total mercury and antagonistic interaction between selenium and total mercury with selected birth outcomes.

CONCLUSIONS

Our findings suggest that prenatal exposure to metals may be related to birth outcomes, and infant sex may modify these associations.

Interactions between environmental pollutants and dietary nutrients: current evidence and implications in epidemiological research

Environmental pollutants and nutrients may be present in the same foodstuffs or dietary patterns; share internal mechanisms of transport, metabolism and cellular uptake; or target the same molecular signalling pathways and biological functions. Lipophilic pollutants and nutrients, like dioxins and polyunsaturated fatty acids, may often converge at all aforementioned levels and thus the interactions become more likely. Despite this fact, the topic seems overlooked in mainstream epidemiological research. In this essay, we illustrate different levels of documented interactions between pollutants and nutrients with experimental, interventional and epidemiological evidence, paying special attention to lipophilic chemicals. We first describe common pollutants and nutrients encountered in diets and the internal lipophilic interface such as adipose tissue and serum lipids. Next, we discuss the preventive effects of nutrients against absorption and the toxic effects of pollutants, as well as the pollutant-induced perturbation of nutrient metabolism. Finally, we discuss the implications of nutrient-pollutant interactions in epidemiology, providing some examples of negative confounding, modification effect and statistical interactions reported for different outcomes including fetal growth, diabetes and cancer. The evidence discussed in this essay supports that the health impacts of chemicals have likely been underestimated due to the high risk of residual and coexposure confounding in diseases where interactions between pollutants and nutrients may occur.

Toxic metal (Cd, Hg, Mn, Pb) partition in the maternal/foetal unit: A systematic mini - review of recent epidemiological studies

The aim of this study was to summarise the available information regarding the partition of toxic metal (Cd, Hg, Mn, Pb) levels in the maternal/foetal unit from large epidemiological studies. We performed a systematic search of PubMed/MedLine, EMBASE, and ISI Web of Science for papers on Cd, total Hg, Mn or Pb levels in the maternal/cord blood that were published in English (n > = 200; 2010-2017). Data on year of publication, sample size, location, year of survey, and main results were extracted. We found a total of 35 papers. Most studies included large convenience samples of healthy pregnant women. The maternal/cord blood was properly used as a biomarker of prenatal exposure to toxic metals. The partition of these toxic metal levels in the maternal/foetal unit was metal-specific. Cd median levels (IQR) in cord blood reported worldwide were much lower [∼ 70 % < LOD = ± 0.11 μg/L] than those found in maternal blood [0.23 μg/L (0.15-0.35), ∼ 65 % > LOD]. Considering that Cd was under LOD in 70 % of the cord blood, Cd cord:maternal ratio as well as Cd cord proportion were not provided. Total Hg median levels (IQR) in cord blood [0.75 μg/L (0.40-1.19), ∼30 % < LOD = ±0.35 μg/L] were usually higher than in maternal blood [0.55 μg/L (0.40-0.85), ∼ 10 % < LOD = ±0.15 μg/L]. Hg cord:maternal ratio was 1.34 (1.00-1.91), and infants born would have Hg cord:(cord + maternal) proportion ranged from 0.50 to 0.63. Mn was the only metal that was detected in 100 % in both maternal (LOD : ±0.50 μg/L) and cord (LOD = ±0.2 μg/L) blood. Mn median levels (IQR) in cord blood [32.96 μg/L (26.90-40.10)] were 2 times higher than in maternal blood [14.01 μg/L (11.50-17.58)]. Mn cord:maternal ratio was 2.35 (1.09-3.80), and infants born would have Mn proportion ranged from 0.52 to 0.79. Pb median levels (IQR) in cord blood [5.79 μg/L (4.34-8.38), ∼ 5% < LOD : ±2.07 μg/L] were usually equal to or lower than those reported in maternal blood [8.07 μg/L (5.79-10.76), ∼ 1% < LOD = ±1.03 μg/L]. Pb cord:maternal ratio was 0.71 (0.59-0.96), and infants born would have Pb proportion ranged from 0.37 to 0.49. Globally, the results indicate that total Hg and Mn levels were lower in maternal blood but higher in cord blood. However, much greater variability was seen with Cd and Pb. At delivery, total Hg and Pb levels in maternal blood were strong predictors of cord blood levels. Our findings empty that understanding the partition, levels and correlations of toxic metals in the maternal/cord blood may help to elucidate the adverse effects of these metals on foetuses and neonates.

Predictors and reproducibility of urinary organophosphate ester metabolite concentrations during pregnancy and associations with birth outcomes in an urban population

BACKGROUND

Organophosphate esters (OPEs) are synthetic chemicals used as flame retardants and plasticizers in a variety of goods. Despite ubiquitous human exposures and laboratory evidence that prenatal OPE exposures may disrupt offspring metabolism, perinatal studies of OPE health effects are limited. The objectives of this study were to: 1) Determine predictors and reproducibility of urinary OPE biomarker concentrations during pregnancy, and 2) Estimate the relation of prenatal OPE exposures with birth outcomes and cord blood adipokine and insulin concentrations.

METHODS

We analyzed five OPE metabolites in urine samples collected at up to three visits during pregnancy from 90 women enrolled in the ORigins of Child Health And Resilience in Development (ORCHARD) pregnancy cohort in Baltimore, MD from 2017 to 2019. To quantify the variability of metabolite concentrations during pregnancy, we calculated intraclass correlation coefficients (ICCs) for each metabolite using mixed effects regression models. Using self-reported questionnaire data collected during gestation, we assessed possible sociodemographic and environmental/behavioral predictors of each OPE metabolite using generalized estimating equations to account for repeated exposure measures. We ascertained birth outcomes of 76 offspring from medical records, including weight-for-gestational age, length, ponderal index, and gestational age. In a subset of 37 infants, we measured cord blood concentrations of leptin, adiponectin, and insulin. To account for repeated exposure measures, we used linear structural equation models to assess the relations of standard deviation (SD) increases in prenatal OPE metabolite factor scores with continuous birth outcomes and cord blood biomarker concentrations.

RESULTS

ICCs ranged from 0.09 for isopropylphenyl-phenyl phosphate (ip-PPP) to 0.59 for bis(1,3-dichloro-2-propyl) phosphate (BDCIPP). We observed little consistency in environmental or behavioral predictors of OPE exposures, although concentrations were generally lower for samples collected in the afternoon compared to morning and winter compared to other seasons. In adjusted analyses, a SD increase in BDCIPP concentration was associated with a 0.06 g/cm3 (95% CI: 0.00, 0.12) greater ponderal index. A SD increase in BDCIPP was associated with a 0.37 (95% CI: - 0.62, - 0.13) SD lower insulin concentration and 0.24 (95% CI: - 0.39, - 0.08) SD lower leptin concentration. Other OPEs were not associated with infant outcomes.

CONCLUSIONS

These findings suggest some OPEs may be metabolic disruptors warranting investigation in larger studies.

Association between mercury in cord serum and sex-specific DNA methylation in cord tissues

Prenatal exposure to mercury in utero causes abnormal foetal growth and adverse outcomes. DNA methylation is currently considered a possible mechanism through which this occurs. However, few studies have investigated the association between prenatal exposure to mercury and DNA methylation in detail. This study aimed to clarify the relationship between prenatal exposure to total mercury (Hg) and DNA methylation and its associations with sex-specific characteristics in male and female offspring. In a birth cohort study known as the Chiba study of Mother and Child Health, the DNA methylation status in cord tissue and Hg concentrations in cord serum were examined. A total of 67 participants (27 males and 40 females) were analysed based on Spearman's correlations, adjusted by a false discovery rate of the sex of each offspring. Only one methylated locus was positively correlated with Hg concentrations in cord serum in male offspring, but not in female offspring, and was annotated to the haloacid dehalogenase-like hydrolase domain-containing protein 1 (HDHD1) gene on chromosome X. This locus was located in the intron of the HDHD1 gene body and is a binding site for the zinc finger protein CCCTC-binding factor. One of the other loci, located in HDHD1, was highly methylated in the group with higher mercury concentrations, and this locus was in the gene body of HDHD1. Our results suggest that prenatal exposure to Hg might affect the epigenetic status of male foetuses.

Simultaneous exploration of nutrients and pollutants in human milk and their impact on preterm infant growth: An integrative cross-platform approach

Early nutritional management including fortified human breastmilk is currently recommended to fulfil the energy demands and counterbalance risks associated to preterm birth. However, little is known about the potential adverse effects of exposure to persistent organic pollutants (POPs) carried in human milk on preterm infant growth. We conducted a pilot study proving the application of an integrative analytical approach based on mass spectrometry (MS) coupled to advanced statistical models, favouring the comprehensive molecular profiling to support the identification of multiple biomarkers. We applied this workflow in the frame of a preterm infants' cohort to explore environmental determinants of growth. The combination of high resolution gas and liquid chromatography MS platforms generated a large molecular profile, including 102 pollutants and nutrients (targeted analysis) and 784 metabolites (non-targeted analysis). Data analysis consisted in a preliminary examination of associations between the signatures of POPs and the normalised growth of preterm infants, using multivariate linear regression adjusting for known confounding variables. A second analysis aimed to identify multidimensional biomarkers using a multiblock algorithm allowing the integration of multiple datasets in the growth model of preterm infants. The preliminary results did not suggest an impairment of preterm growth associated to the milk concentrations of POPs. The multiblock approach however revealed complex interrelated molecular networks of POPs, lipids, metabolites and amino acids in breastmilk associated to preterm infant growth, supporting the high potential of biomarkers exploration of this proposed workflow. Whereas the present study intended to identify simultaneously pollutant and nutrient exposure profiles associated to early preterm infant growth, this workflow may be easily adapted and applied to other matrices (e.g. serum) and research settings, favouring the functional exploration of environmental determinants of complex and multifactorial diseases.

Prenatal Se concentrations and anthropometry at birth in the INMA study (Spain)

We assessed whether prenatal selenium (Se) exposure is associated with anthropometry at birth, placental weight and gestational age. Study subjects were 1249 mother-child pairs from the Valencia and Gipuzkoa cohorts of the Spanish Childhood and Environment Project (INMA, 2003-2008). Se was determined in serum samples taken at the first trimester of pregnancy. Socio-demographic and dietary characteristics were also collected by questionnaires. Mean (SD) serum Se concentration was 79.57 (9.64) μg/L. Se showed weak associations with both head circumference and gestational age. The association between serum Se concentration and birth weight and length was negative, and direct for placental weight and probability of preterm birth, although the coefficients did not reach statistical significance. Individuals with total mercury (THg) levels >15 μg/L reversed the serum Se concentration effect on head circumference. Significant interactions were found between sex and both gestational age and prematurity. Spontaneous birth gestational ages were estimated to be lower for males and their probability of prematurity was higher. In conclusion, prenatal Se exposure may be associated with lower head circumference and lower gestational ages at spontaneous birth. Interactions with THg exposure and gender should be considered when assessing these relationships.

Blood metal levels and early childhood anthropometric measures in a cohort of Canadian children

Fetal exposure to some toxic metals has been associated with reduced fetal growth, but the impact of contemporary, low-level metals on anthropometric measures in childhood is not well understood. Our primary objective was to quantify associations between childhood levels of toxic metals and concurrently measured body mass index (BMI) in a population of Canadian preschool-aged children. We collected biomonitoring data and anthropometric measures on 480 children between the ages of two and five years in the Maternal-Infant Research on Environmental Chemicals (MIREC) Child Development Plus study. Concentrations of four toxic metals (lead, arsenic, cadmium, and mercury) were measured in whole blood collected from pregnant women and their children. Blood levels of key essential elements were also measured in children. Children's weight, height, and BMI z-scores were calculated using the World Health Organization growth standards. We used a series of linear regression models, adjusted for potential parental confounders, concurrently measured metals and elements, and prenatal blood metal levels, to evaluate associations between tertiles of each toxic metal and anthropometric measures. We tested for effect modification by sex. Of the 480 children, 449 (94%) were singleton births and had complete biomonitoring and anthropometric data. The majority of children had detectable concentrations of metals. In the adjusted models, girls with blood lead concentrations in the highest tertile (>0.82 μg/dL) had, on average, 0.26 (95% Cl: -0.55, 0.03) lower BMI z-scores than those in the referent category. In contrast, boys with lead levels in the highest tertile had, on average, 0.14 higher BMI z-scores (95% Cl: -0.14, 0.41) (p-value heterogeneity = 0.04). In this population of Canadian preschool-aged children with low-level blood lead concentrations, we observed effect modification by sex in the association between Pb and BMI but no statistically significant associations in the sex-specific strata. Child blood levels of As, Cd, and Hg were not associated with childhood BMI, weight, or height in boys or girls.

Urinary Biomarker of Prenatal Exposure to Disinfection Byproducts, Maternal Genetic Polymorphisms in CYP2E1 and GSTZ1, and Birth Outcomes

The effects of disinfection byproducts (DBPs) on adverse birth outcomes remain unsettled. Maternal genetic variants in relation to DBP metabolism may modify this effect. Pregnant women during late pregnancy (n = 1306) were included from a Chinese cohort. Maternal urinary trichloroacetic acid (TCAA) was measured as a biomarker of DBP exposure. Maternal genotyping was conducted in cytochrome P450 2E1 (CYP2E1; rs2031920, rs3813867, and rs915906) and glutathione S-transferase zeta-1 (GSTZ1; rs7975). The associations between maternal urinary TCAA and birth outcomes and statistical interactions between maternal exposure and genetic polymorphisms were estimated. We found that maternal urinary TCAA levels were associated with decreased birth weight (P for trend = 0.003) and ponderal index (P for trend = 0.004). Interaction analyses showed that maternal urinary TCAA in association with decreased birth weight was observed only among subjects with CYP2E1 rs3813867 GC/CC versus GG (P_int = 0.07) and associations with decreased birth length, ponderal index, and gestational age were observed only among subjects with GSTZ1 rs7975 GA/AA versus GG (P_int = 0.07, 0.02, and 0.02, respectively). Our results suggested that prenatal DBP exposure was negatively associated with birth weight and ponderal index, and maternal genetic polymorphisms in CYP2E1 and GSTZ1 might modify these associations.

Mercury speciation in prenatal exposure in Slovenian and Croatian population - PHIME study

In recent years, several studies have addressed the issue of prenatal exposure to methylmercury (MeHg); however, few have actually analysed MeHg blood concentrations. Our study population included mothers and their new-borns from Slovenia (central region; N = 584) and Croatia (coastal region; N = 234). We have measurements of total Hg (THg) and MeHg in maternal hair, maternal peripheral blood, and cord blood. Cord blood Hg concentrations were low to moderate (median THg = 1.84 ng/g and MeHg = 1.69 ng/g). The proportion of THg as MeHg (%MeHg) in maternal and cord blood varied between 4% and 100% (coefficient of variation, CV = 32%) and between 8% and 100% (CV = 20%), respectively. Our data shows that variability of %MeHg was higher at lower blood THg levels. Concentrations of MeHg in maternal blood and cord blood were highly correlated (R_s = 0.943), in the case of inorganic Hg correlation was significant but weaker (R_s = 0.198). MeHg levels in maternal blood and cord blood were positively associated with seafood intake, maternal age, and negatively associated with pre-pregnancy BMI. Additionally, MeHg in maternal blood was positively associated with plasma selenium levels, and cord blood MeHg was negatively associated with parity. The results of multiple linear regression models showed that speciation analysis provides more defined estimation of prenatal exposure in association modelling. Associations between Hg exposure and cognitive performance of children (assessed using Bayley Scales of Infant and Toddler development) adjusted for maternal or child Apolipoprotein E genotypes showed higher model R² and lower p-values when adjusted for MeHg compared to THg. This study demonstrates that Hg speciation improves the association between exposure and possible negative health effects.

Prenatal and Early Postnatal Exposure to Total Mercury and Methylmercury from Low Maternal Fish Consumption

The aim of this study was to investigate the influence of low fish consumption on prenatal and early postnatal exposure to mercury species. The samples of umbilical cord blood and maternal milk as well as interviewer-administered questionnaires were collected from 142 Slovak mother-child pairs. The mean total mercury (THg) concentrations in cord blood and milk were 0.949 μg/L and 0.376 μg/kg, respectively. The mean methylmercury (MeHg) concentration in cord blood was 0.504 μg/L. Fish eaters had significantly higher cord blood MeHg concentrations than non-fish eaters (p = 0.030); no difference was found in milk or cord blood THg concentrations. The bivariate analysis showed a positive correlation between cord blood MeHg and consumption of sea fish and shellfish (r_s = 0.320, p < 0.001); after adjustment for the potential confounders, the association was weakened (β = 0.173, p = 0.059). Nevertheless, the decision tree method showed sea fish and shellfish consumption to be the best predictor of cord blood MeHg. Furthermore, a negative association was found between THg concentrations in maternal milk and freshwater fish consumption (β = - 0.193, p = 0.017), which might indicate a beneficial effect of freshwater fish consumption. The results suggest there is a need for future research to investigate the benefits versus the adverse effects of low maternal fish consumption on child development.

Association of blood mercury levels during pregnancy with infant birth size by blood selenium levels in the Japan Environment and Children's Study: A prospective birth cohort

BACKGROUND

It is necessary to determine whether there are adverse health effects of prenatal exposure to long-term, low levels of mercury and selenium. However, there are limited that reports on the association between mercury levels by selenium levels and birth size. Therefore, we examined whether maternal mercury levels during pregnancy had any effect on infant birth size, and size, and whether selenium levels influenced this relationship.

OBJECTIVES

To examine the association between mercury and selenium levels during pregnancy with infant birth size.

METHODS

The Japan Environment and Children's Study is a prospective birth cohort conducted between 2011 and 2014. Total mercury levels and total selenium levels in maternal blood during the second and third trimesters were measured using Inductively Coupled Plasma-Mass Spectrometry. Birth weight and small-for-gestational-age were confirmed by medical records. Small-for-gestational-age was defined as birth weight below the 10th percentile according to standard percentile for gender, parity, and gestational age. Multiple linear and logistic regression analyses were used to examine the association between maternal mercury exposure and birth weight or small-for-gestational-age adjusted for confounders (including maternal age and body mass index pregnancy).

RESULTS

Overall, 15,444 pregnant women were included in this study. Median (inter-quartile range) of blood mercury and selenium levels were 3.66 (2.59-5.18) ng/g and 170.0 (158.0-183.0) ng/g, respectively. Compared to infants of mothers with the highest blood selenium level, those of mothers with the lowest blood selenium level had neither a significant birth weight increase (9 g, 95% confidence interval: -6, 25) nor a significant odds ratio for small-for-gestational-age (0.903, 95% confidence interval: 0.748, 1.089). Compared to infants of mothers with the lowest blood mercury level, those of mothers with the highest blood mercury level had neither a significant birth weight reduction (-12 g, 95% confidence interval: -27, 4) nor a significant odds ratio for small-for-gestational-age (0.951, 95% confidence interval: 0.786, 1.150). Compared to infants of mothers with the lowest quartile of maternal blood mercury level, all infants of mothers with the highest quartile of maternal blood mercury level had a reduced birth head circumference of 0.073 cm (95% confidence interval: -0.134, -0.011).

CONCLUSIONS

There was no association between maternal blood mercury levels and small-for-gestational-age and birth weight among 15,444 pregnant women. In a Japanese population, which has a relatively higher blood mercury level than reported in Western population, reduced birth size was not found to be associated with blood mercury levels, with the exception of birth head circumference.

Placental metal concentrations and birth outcomes: The Environment and Childhood (INMA) project

OBJECTIVE

To examine the association of placental levels of arsenic (As), cadmium (Cd), mercury (Hg), lead (Pb), manganese (Mn), and chromium (Cr) with birth outcomes (birth weight, length, and head circumference, low birth weight [LBW], gestational age, preterm delivery, and small for gestational age [SGA]) in mother-child pairs from the Environment and Childhood (INMA) Project in Spain.

METHODS

Metal concentrations were measured in placenta tissue samples randomly selected from five INMA cohorts. Data on birth outcomes were obtained from medical records. Associations were assessed in a sub-sample of 327 mother-infant pairs by regression models adjusted for confounding factors and for all metals simultaneously. Effect modification by sex was also evaluated.

RESULTS

Elevated placental Cd levels (>5.79 vs. <3.30 ng/g) were associated with reduced birth weight (-111.8 g, 95%CI = -215.6; -8.06, p-trend = 0.01) and length (-0.62 cm, 95%CI = -1.20; -0.04, p-trend = 0.02), while a 10% increase in Cd was associated with 1.21-fold increased odds (95%CI = 1.01; 1.43) of LBW in the global sample but with 14% lower odds (95%CI = 0.78; 0.96) of preterm delivery in males (P_interaction = 0.10). Detected (vs. undetected) Hg was associated with reduced head circumference (-0.49 cm, 95%CI = -1.00; 0.03) in females (P_interaction = 0.03). A 10% increase in placental Mn was associated with slight increases in gestational age (0.04 weeks, 95%CI = 0.01; 0.07) in the global sample and in head circumference (0.05 cm, 95%CI = -0.01; 0.10) in females (P_interaction = 0.03). Elevated Cr levels (>99.6 vs. <56.1 ng/g) were associated with reduced birth length (-0.68 cm, 95%CI = -1.33; -0.04, p-trend = 0.02) and slightly increased gestational age (0.35 weeks, 95%CI = -0.07; 0.77, p-trend = 0.08) in the global sample. As and Pb were detected in few placentas (27% and 13%, respectively) and were not associated with any studied birth outcome.

CONCLUSIONS

Data suggest that in utero exposure to Cd, Hg, and Cr could adversely affect fetal growth, whereas Mn and Cr appear to have a positive effect on gestational age. Given the relatively small number of subjects, sex-specific associations should be interpreted with caution.

Development of a Cumulative Exposure Index (CEI) for Manganese and Comparison with Bone Manganese and Other Biomarkers of Manganese Exposure

Manganese (Mn) exposure can result in parkinsonism. However, understanding of manganese neurotoxicity has been limited by the lack of a cumulative Mn biomarker. Therefore, the current goal was to develop Mn cumulative exposure indices (MnCEI), an established method to estimate cumulative exposure, and determine associations of MnCEI with blood Mn (BMn), fingernail Mn (FMn), and bone Mn (BnMn). We completed a cross-sectional study of 60 male Chinese workers. Self-reported occupational history was used to create two MnCEIs reflecting the previous 16 years (MnCEI₁₆) and total work history (MnCEI_TOT). An in vivo neutron activation analysis system was used to quantify BnMn. BMn and FMn were measured using ICP-MS. Mean (standard deviation) MnCEI_TOT and MnCEI₁₆ were 37.5 (22.0) and 25.0 (11.3), respectively. Median (interquartile range) BMn, FMn, and BnMn were 14.1 (4.0) &mu;g/L, 13.5 (58.5) &mu;g/g, and 2.6 (7.2) &mu;g/g dry bone, respectively. MnCEI₁₆ was significantly correlated with FMn (Spearman&rsquo;s &rho; = 0.44; p = 0.02), BnMn (&rho; = 0.44; p < 0.01), and MnCEI_TOT (&rho; = 0.44; p < 0.01). In adjusted regression models, MnCEI₁₆ was significantly associated with BnMn (&beta; = 0.03; 95% confidence interval = 0.001, 0.05); no other biomarkers were associated with MnCEI. This suggests BnMn may be a useful biomarker of the previous 16 years of Mn exposure, but larger studies are recommended.

Prenatal exposure to mercury and longitudinally assessed fetal growth: Relation and effect modifiers

BACKGROUND

Prenatal mercury exposure has been related to reductions in anthropometry at birth. Levels of mercury have been reported as being relatively elevated in the Spanish population.

OBJECTIVE

To investigate the relation between prenatal exposure to mercury and fetal growth.

METHODS

Study subjects were pregnant women and their newborns (n:1867) participating in a population-based birth cohort study set up in four Spanish regions from the INMA Project. Biparietal diameter (BPD), femur length (FL), abdominal circumference (AC), and estimated fetal weight (EFW) were measured by ultrasounds at 12, 20, and 34 weeks of gestation. Size at and growth between these points were assessed by standard deviation (SD) scores adjusted for constitutional characteristics. Total mercury (T-Hg) was determined in cord blood. Associations were investigated by linear regression models, adjusted by sociodemographic, environmental, nutritional - including four seafood groups - and lifestyle-related variables in each sub-cohort. Final estimates were obtained using meta-analysis. Effect modification by sex, seafood intake and polychlorinated biphenyl (PCB) congener 153 concentration was assessed.

RESULTS

Geometric mean of cord blood T-Hg was 8.2μg/L. All the estimates of the association between prenatal Hg and growth from 0 to 12 weeks showed reductions in SD-scores, which were only statistically significant for BPD. A doubling of cord blood T-Hg was associated with a 0.58% reduction in size of BPD at week 12 (95% confidence interval -CI-: - 1.10, - 0.07). Size at week 34 showed estimates suggestive of a small reduction in EFW, i.e., a doubling of T-Hg levels was associated with a reduction of 0.38% (95% CI: - 0.91, 0.15). An interaction between PCB153 and T-Hg was found, with statistically significant negative associations of T-Hg with AC and EFW in late pregnancy among participants with PCB153 below the median.

CONCLUSIONS

Exposure to mercury during pregnancy was associated with early reductions in BPD. Moreover, an antagonism with PCB 153 was observed with noteworthy reductions late in pregnancy in AC and EFW in the group with lower PCB153.

Development and application of a novel method to characterize methylmercury exposure in newborns using dried blood spots

BACKGROUND

Methylmercury (MeHg) is a pollutant of global concern. While there is a need to gauge early-life exposures, there remain outstanding ethical, financial, and practical challenges with using the preferred biomarker, whole blood, notably in pregnant women, infants, toddlers, and children. Dried bloodspots (DBS) may help overcome some of these challenges. Notably DBS are collected from newborns in many jurisdictions offering an institutionalized platform to efficiently characterize exposures.

OBJECTIVE

To develop, validate, and apply a new method to measure MeHg levels in DBS with a specific aim to use this method to increase understanding of newborn exposures.

METHODS

Method development and validation was pursued by consulting U.S. EPA Method 1630 and other resources. The method was applied to measure MeHg levels in DBS from newborns (n = 675) from the Michigan BioTrust for Health program.

RESULTS

The assay's detection limit (0.3μg/L), accuracy (96-115% of expected), precision, linearity, and range met performance criteria guidelines. In the newborn DBS samples, the mean (SD) and geometric mean values of MeHg were 1.46 (0.90) and 1.25μg/L respectively, and ranged from 0.09 to 9.97μg/L. The values we report here are similar to cord blood mercury values reported elsewhere.

CONCLUSIONS

This is the first characterization of MeHg exposure in newborns, and thus fills an important data gap as prior studies have focused on pregnant women, cord blood, or toddlers. This method helps overcome technical challenges associated with other proposed approaches, and moving ahead there is great promise for applying this DBS-based method for population-level surveillance, particularly in resource-limited settings and for children's health.

Sex differences in the effects of prenatal lead exposure on birth outcomes

Studies on the associations between prenatal lead exposure and birth outcomes have been inconsistent, and few data are available on the sex differences in these associations. We measured the cord blood lead levels of newborns in Shanghai and determined their associations with birth outcomes, which included birth weight, birth length, head circumference, and the ponderal index, in the total sample and within sex subgroups. A total of 1009 mother-infant pairs were enrolled from 10 hospitals in Shanghai between September 2008 and October 2009. The geometric mean of the cord blood lead concentrations was 4.07 μg/dl (95% CI: 3.98-4.17 μg/dl). A significant inverse association was found between cord blood lead levels and head circumference only in the male subgroup, and increasing cord blood lead levels were related to significant decreases in the ponderal index only in females. The birth weights of the male infants were positively associated with cord blood lead levels; after adjusting for the maternal intake frequency of preserved eggs, the estimated mean differences in birth weights decreased by 11.7% for each 1-unit increase in the log10-transformed cord blood lead concentration. Our findings suggest that prenatal lead exposure may have sex-specific effects on birth outcomes and that maternal dietary intake may be a potential confounder in these relationships. Further studies on this topic are highly warranted.

Determinants of polyunsaturated fatty acid concentrations in erythrocytes of pregnant Japanese women from a birth cohort study: study protocol and baseline findings of an adjunct study of the Japan environment & Children's study

BACKGROUND

N-3 polyunsaturated fatty acids (n-3 PUFA) may have multiple beneficial effects on the outcome of pregnancy, maternal health and child development. The present study introduced the protocol of a birth cohort study to examine the beneficial effects of n-3 PUFA status in pregnant Japanese women as an adjunct study of the Japan Environment and Children's Study (JECS).

METHODS

The JECS participants in the coastal areas of Miyagi Prefecture were further invited to participate in this adjunct study, and 1,878 pregnant women were enrolled prior to delivery. Their n-3 PUFA status was evaluated with fatty acid profiles in erythrocytes of maternal blood collected from 1,623 mothers at 24-30 weeks of gestation and cord blood from 1,505 deliveries.

RESULTS

The baseline results, including comprehensive data on the fatty acid status and determinants affecting the PUFA status, were analyzed. In stepwise multivariate analyses, the cord blood docosahexaenoic acid (DHA) level was found to be significantly influenced by the DHA level in maternal blood, the child's sex, and the gestational period. The maternal DHA level was influenced by fish intake, maternal age, and the prepregnancy body mass index. While cord blood eicosapentaenoic acid (EPA) was influenced by maternal EPA, fish intake, and season at birth, additional factors such as maternal education, household income, and smoking habits affected the maternal EPA content.

CONCLUSION

Further studies are warranted to clarify the nutritional impacts of n-3 PUFA in pregnant Japanese women of the cohort study.

Dietary patterns of early childhood and maternal socioeconomic status in a unique prospective sample from a randomized controlled trial of Prenatal DHA Supplementation

BACKGROUND

Dietary habits established in early childhood and maternal socioeconomic status (SES) are important, complex, interrelated factors that influence a child's growth and development. The aim of this study was to define the major dietary patterns in a cohort of young US children, construct a maternal SES index, and evaluate their associations.

METHODS

The diets of 190 children from a randomized, controlled trial of prenatal supplementation of docosahexaenoic acid (DHA) were recorded at 6-mo intervals from 2-4.5 years by 24-h dietary recall. Hierarchical cluster analysis of age-adjusted, average daily intake of 24 food and beverage groups was used to categorize diet. Unrotated factor analysis generated an SES score from maternal race, ethnicity, age, education, and neighborhood income.

RESULTS

We identified two major dietary patterns: "Prudent" and "Western." The 85 (45%) children with a Prudent diet consumed more whole grains, fruit, yogurt and low-fat milk, green and non-starchy vegetables, and nuts and seeds. Conversely, those with a Western diet had greater intake of red meat, discretionary fat and condiments, sweet beverages, refined grains, French fries and potato chips, eggs, starchy vegetables, processed meats, chicken and seafood, and whole-fat milk. Compared to a Western diet, a Prudent diet was associated with one standard deviation higher maternal SES (95% CI: 0.80 to 1.30).

CONCLUSIONS

We found two major dietary patterns of young US children and defined a single, continuous axis of maternal SES that differed strongly between groups. This is an important first step to investigate how child diet, SES, and prenatal DHA supplementation interact to influence health outcomes.

TRIAL REGISTRATION

NCT00266825 . Prospectively registered on December 15, 2005.

Prenatal mercury exposure and birth outcomes

BACKGROUND

Results regarding the association between mercury exposure and anthropometry at birth, gestational length and placental weight are inconsistent, as is the role of seafood intake in these associations.

OBJECTIVE

We assessed whether prenatal mercury exposure is associated with anthropometry at birth, placental weight and gestational length in a population with a relatively high exposure to mercury from seafood consumption.

METHODS

Total mercury (T-Hg) was determined in cord blood from 1869 newborns with birth outcome measures, within the Spanish multicenter INMA cohort from 2004 to 2008. We adjusted cohort specific linear and Cox regression models to evaluate the association between T-Hg and birth anthropometry (weight, length, and head circumference), placental weight and gestational length. Non-spontaneous labor was taken to be censoring in the survival analysis. Final estimates were obtained using meta-analysis.

RESULTS

Geometric mean T-Hg was 8.2μg/L. A doubling of T-Hg was associated with a 7.7g decrease in placental weight (95% CI: -13.6, -1.8) and marginally with head circumference (beta: -0.052cm, 95% CI: -0.109, 0.005). T-Hg was also inversely related to weight and length, although with weaker estimates. Mercury exposure was not associated with the length of gestation. The inverse relation between T-Hg and growth was enhanced when the intake of different seafood groups was adjusted for in the models.

CONCLUSIONS

Prenatal mercury exposure may be associated with reduced placental and fetal growth. Confounding by fish intake should be considered when assessing these relationships.

Blood mercury levels and fish consumption in pregnancy: Risks and benefits for birth outcomes in a prospective observational birth cohort

Background

To avoid exposure to mercury, government advice on fish consumption during pregnancy includes information on fish species to avoid and to limit, while encouraging consumption of least two portions of fish per week. Some women may, however, chose to avoid fish completely during pregnancy despite potential benefits to the fetus.

Objectives

Our aims were to evaluate the effects of blood mercury levels in pregnant women on birth outcomes in the UK, and to compare outcomes in those who ate fish with those who did not.

Methods

Pregnant women were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples for singleton pregnancies with a live birth were analysed for Hg by inductively coupled plasma dynamic reaction cell mass spectrometry (n = 4044). Fish intake was determined by a food frequency questionnaire during pregnancy. Data collected on the infants included anthropometric variables and gestational age at delivery. Regression models were adjusted for covariates using SPSS v23.

Results

There were no significant associations of maternal blood Hg level with birthweight, head circumference or crown–heel length in adjusted linear regression models. Similarly, there were no increased odds of low birthweight or preterm delivery in adjusted logistic regression models. When the models were repeated after stratification into fish-eaters and there were no associations except for a negative association with birthweight in non-fish-eaters (unstandardised B coefficient −58.4 (95% confidence interval −113.8, −3.0) g, p = 0.039).

Conclusion

Moderate mercury levels in pregnancy were not associated with anthropometric variables, or on the odds of low birthweight or preterm birth. Fish consumption may have a protective effect on birthweight. Consumption of fish in line with government guidelines during pregnancy should be encouraged.

[Recent Epidemiological Studies on Methylmercury, Mercury and Selenium]

More than sixty years has passed since the outbreak of Minamata disease, and high-level methylmercury contaminations now seem nonexistent in Japan. However, mercury has been continuously discharged from natural sources and industrial activities, and the health effects on children susceptible to methylmercury exposure at low levels, in addition to mercury contamination from mercury or gold mining areas in developing countries, become a worldwide concern. In this article, we provide a recent overview of epidemiological studies regarding methylmercury and mercury. The following findings were obtained. (1) Many papers on exposure assessment of methylmercury/mercury have been published since the Minamata Convention on Mercury was adopted in 2013. (2) The most crucial problem is child developmental neurotoxicity resulting from prenatal exposure to methylmercury, but its precise assessment seems to be difficult because most of such effects are neither severe nor specific. (3) Several problems raised in birth cohort studies (e.g., whether IQ deficits due to prenatal methylmercury exposure remain when the children become adults, or whether the postnatal exposure at low levels also causes such adverse effects in children) remain unsolved. (4) Concurrent exposure models of methylmercury, lead, polychlorinated biphenyls, aresenic, and organochlorine pesticides, as well as possible antagonists such as polyunsaturated fatty acids and selenium, should be considered in the study design because the exposure levels of methylmercury are extremely low in developed countries. (5) Further animal experiments and molecular biological studies, in addition to human studies, are required to clarify the mechanism of methylmercury toxicity.