PMID- 35533713 OWN - NLM STAT- MEDLINE DCOM- 20220620 LR - 20220808 IS - 1096-0953 (Electronic) IS - 0013-9351 (Linking) VI - 212 IP - Pt C DP - 2022 Sep TI - Maternal exposure to heavy metals and risk for severe congenital heart defects in offspring. PG - 113432 LID - S0013-9351(22)00759-9 [pii] LID - 10.1016/j.envres.2022.113432 [doi] AB - BACKGROUND: Congenital heart defects (CHDs) are the most common congenital malformations with a complex etiology, and environmental factors play an important role. Large epidemiology studies on prenatal exposure to selected heavy metals and their association with risk for CHDs are scarce and joint effects are not well understood. OBJECTIVES: To examine the association between prenatal exposure to selected heavy metals and risk for CHDs. METHODS: Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine the maternal plasma concentrations of arsenic, cadmium, mercury, lead, and manganese were in 303 CHD cases and 303 healthy controls that were recruited in eight hospitals in China. Generalized linear mixed model (GLMM) and Bayesian kernel machine regression (BKMR) were fitted to evaluate the individual and joint effects of metal concentrations on CHDs. RESULTS: In GLMM, two metals were each significantly associated with an increased risk for CHDs [adjusted odds ratio (95% confidence interval): mercury, 2.88 (1.22-6.77); lead, 2.74 (1.00-7.57)]. In BKMR, CHD risk increased with mixture levels of the five metals when their concentrations were at the 40th percentile or higher, compared to when all metals were below their 35th percentile, and mercury was the major metal that contributed to the mixture effect. The interaction between mercury and lead was observed in BKMR. CONCLUSIONS: Using metal concentrations in maternal plasma obtained during the second or third trimester as exposure markers, we found that the risk of CHDs increased with the levels of the mixtures of As, Cd, Hg, Pb, and Mn, with Hg being the most important contributor to the mixture effect. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Wang, Chengrong AU - Wang C AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Pi, Xin AU - Pi X AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China. FAU - Yin, Shengju AU - Yin S AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, China. FAU - Liu, Mengyuan AU - Liu M AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Tian, Tian AU - Tian T AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Jin, Lei AU - Jin L AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Liu, Jufen AU - Liu J AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Li, Zhiwen AU - Li Z AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Wang, Linlin AU - Wang L AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. FAU - Yuan, Zhengwei AU - Yuan Z AD - Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China. FAU - Wang, Yu AU - Wang Y AD - Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China. Electronic address: wangyu_us@hotmail.com. FAU - Ren, Aiguo AU - Ren A AD - Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. Electronic address: renag@bjmu.edu.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220506 PL - Netherlands TA - Environ Res JT - Environmental research JID - 0147621 RN - 0 (Metals, Heavy) RN - FXS1BY2PGL (Mercury) SB - IM MH - Bayes Theorem MH - Female MH - *Heart Defects, Congenital/chemically induced/epidemiology MH - Humans MH - Maternal Exposure/adverse effects MH - *Mercury/analysis MH - *Metals, Heavy/analysis/toxicity MH - Pregnancy MH - *Prenatal Exposure Delayed Effects OTO - NOTNLM OT - Bayesian kernel machine regression OT - Congenital heart defects OT - Heavy metals OT - Lead OT - Mercury EDAT- 2022/05/10 06:00 MHDA- 2022/06/22 06:00 CRDT- 2022/05/09 19:22 PHST- 2022/02/04 00:00 [received] PHST- 2022/04/30 00:00 [revised] PHST- 2022/05/02 00:00 [accepted] PHST- 2022/05/10 06:00 [pubmed] PHST- 2022/06/22 06:00 [medline] PHST- 2022/05/09 19:22 [entrez] AID - S0013-9351(22)00759-9 [pii] AID - 10.1016/j.envres.2022.113432 [doi] PST - ppublish SO - Environ Res. 2022 Sep;212(Pt C):113432. doi: 10.1016/j.envres.2022.113432. Epub 2022 May 6.