In Utero Exposure to Metals and Birth Outcomes in an Artisanal and Small-Scale Gold Mining Birth Cohort in Madre de Dios, Peru.
In Utero Exposure to Metals and Birth Outcomes in an Artisanal and Small-Scale Gold Mining Birth Cohort in Madre de Dios, Peru.
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DOI：
10.1289/ehp10557
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发表时间：
2023-09
影响因子：
10.4
通讯作者：
Pan, William K.
中科院分区：
文献类型：
--
作者：
Berky, Axel J.;Weinhouse, Caren;Vissoci, Joao;Rivera, Nelson;Ortiz, Ernesto J.;Navio, Susy;Miranda, J. Jaime;Mallipudi, Andres;Fixen, Emma;Hsu-Kim, Heileen;Pan, William K.
南美洲很少有出生队列评估矿物质和有毒金属对新生儿健康的联合影响。在秘鲁的马德雷德迪奥斯，由于手工采金业，汞暴露十分普遍，但其对新生儿健康的影响尚不清楚。我们的目的是确定有毒金属是否与出生体重较低和胎龄较短有关，而不依赖于产前护理和其他母亲健康因素。数据来自COHORTE DE纳西米恩托de Madre de Dios（CONAMAD）出生队列，该队列招募了马德雷德迪奥斯妊娠晚期前的孕妇，并在出生时采集了母体和脐带血样本。我们使用结构方程模型（SEM）构建潜在变量的母体金属环境（ME）和胎儿环境（FE）使用浓度的钙，铁，硒，锌，镁，汞，铅，砷测量母体和脐带血，分别。然后，我们评估了潜在变量ME和FE，有毒金属，产前检查，高血压之间的关系，以及它们对胎龄和出生体重的影响。在198名成功登记并在出生时进行随访的母亲中，29%的血液汞水平超过了美国疾病控制和预防中心的阈值，2名母亲超过了血铅的前阈值。当前阈值为。矿物质和有毒金属加载到ME和FE潜变量。ME与FE相关（0.24; 95% CI：0.05，0.45）。FE与较长的胎龄（2.31; 95%CI：4.51）和较重的出生体重相关。汞暴露与健康结果没有直接关系。母体血铅水平每增加1%，胎龄缩短0.05 d（95% CI：，），在阈值时，导致新生儿妊娠天数减少3.6 d，出生体重减少。产前检查与出生结局的改善相关，从6到12次检查加倍，妊娠天数增加5.5天（95% CI：1.6，9.4），出生体重增加（95% CI：287.6，350.7）。母体铅，即使在低暴露量下，也与较短的妊娠期和较低的出生体重有关。仅关注有害暴露或营养的研究可能会错误描述动态母体ME和FE。SEM提供了一个框架，以评估这些复杂的关系在怀孕期间，并减少过度控制，可能会发生线性回归。https://doi.org/10.1289/EHP10557
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. 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. 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. 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 and 2 mothers surpassed the former threshold for blood lead. The current threshold value is . Minerals and toxic metals loaded onto ME and FE latent variables. ME was associated with FE (0.24; 95% CI: 0.05, 0.45). FE was associated with longer gestational age (2.31; 95% CI: , 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 (; 95% CI: , ), which at the threshold resulted in a loss of 3.6 gestational days and 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 of birth weight (95% CI: 287.6, 350.7). 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
影响因子：
2.9
作者：
Pan WK;Weinhouse C;Ortiz EJ;Berky AJ;Fixsen E;Mallipudi A;Feingold BJ;Navio S;Rivera NA;Hsu-Kim H;Miranda JJ
通讯作者：
Miranda JJ
影响因子：
10.4
作者：
Afeiche M;Peterson KE;Sánchez BN;Cantonwine D;Lamadrid-Figueroa H;Schnaas L;Ettinger AS;Hernández-Avila M;Hu H;Téllez-Rojo MM
通讯作者：
Téllez-Rojo MM
影响因子：
3.7
作者：
Lackner J;Weiss M;Müller-Graf C;Greiner M
通讯作者：
Greiner M