SynthesisJournal of exposure science & environmental epidemiology2021
Cadmium exposure and risk of adverse pregnancy and birth outcomes: a systematic review and dose-response meta-analysis of cohort and cohort-based case-control studies.
Synthesis in Journal of exposure science & environmental epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Prenatal metal(loid) exposure and preterm birth: a systematic review of the epidemiologic evidence.Journal of exposure science & environmental epidemiology · 2025Pooled it
- Dietary interventions to reduce heavy metal exposure in antepartum and postpartum women: a systematic review.Women's health nursing (Seoul, Korea) · 2024Pooled it
- Exposure to heavy metals in utero and autism spectrum disorder at age 3: a meta-analysis of two longitudinal cohorts of siblings of children with autism.Environmental health : a global access science source · 2024Pooled it
- A bioengineered model of human placental exposure to environmental metals during pregnancy.Nature biomedical engineering · 2026Article
- Review
- Association of neonatal metrics, metabolic risk factors, and metal levels in children with obesity.Scientific reports · 2026Article
- Prenatal metal exposures in urban and suburban New York, and a scoping review to compare metal concentrations in meconium across studies.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Intervention Strategies usingEndocrine, metabolic & immune disorders drug targets · 2026Review
- Blood Mercury, Lead, and Cadmium in Association With Fetal Ultrasound Measures During Pregnancy in General Population of Indonesian Expectant Mothers.Environmental health insights · 2026Article
- Article
- Content of selected nutrients and heavy metals in prenatal multivitamins and minerals: an observational study.The American journal of clinical nutrition · 2025Observational
- Article
- Review
- Exposure to heavy metals and trace elements among pregnant women with twins: levels and association with twin growth discordance.Frontiers in public health · 2024Article
- Placental BCRP transporter reduces cadmium accumulation and toxicity in immortalized human trophoblasts.Reproductive toxicology (Elmsford, N.Y.) · 2023Article
- Prenatal Cadmium Exposure and Maternal Sex Steroid Hormone Concentrations across Pregnancy.Toxics · 2023Article
- Protective role of the placental efflux transporter BCRP/ABCG2 in the relationship between prenatal cadmium exposure, placenta weight, and size at birth.Environmental research · 2023Article
- Effects of Non-Essential "Toxic" Trace Elements on Pregnancy Outcomes: A Narrative Overview of Recent Literature Syntheses.International journal of environmental research and public health · 2023Review
- Estimation of health risks associated with dietary cadmium exposure.Archives of toxicology · 2023Review
- Prenatal exposure to heavy metal mixtures and anthropometric birth outcomes: a cross-sectional study.Environmental health : a global access science source · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are several inconsistencies in the epidemiological literature on the strength of the association between cadmium exposure and adverse pregnancy and birth outcomes, and the threshold dose of adverse effect.
objectivesWe therefore conducted a systematic review and dose-response meta-analysis to evaluate the available evidence to influence clinical decision making and better tailor public health interventions.
methodsPubMed and Scopus databases were searched up to January, 2019. Eighteen prospective studies satisfied the inclusion criteria. Random effects model was used to compute summary-effect estimates.
resultsCadmium exposure resulted in 42.11 g (95% confidence interval [CI]: -69.03, -15.18) reduction in birth weight, and 0.105 cm (95% CI: -0.181, -0.029) reduction in head circumference per 1 µg/l increment in blood/urine cadmium levels. Cadmium exposure also resulted in 21% (RR = 1.21; 95% CI: 1.02, 1.43), 32% (RR = 1.32; 95% CI: 1.05, 1.67) and 10% (RR = 1.10; 95% CI: 0.96, 1.27) increased risk of low birth weight (LBW), preterm birth (PTB), and small-for-gestational age (SGA), respectively. Risk for all outcomes decreased with decreasing exposure. In fixed effects dose-response meta-regression analyses, we found no evidence of association of cadmium exposure with LBW and SGA. For PTB, a 1 µg/l increment in cadmium exposure corresponded to 0.5% (OR = 1.005, 95% CI: 1.003, 1.007) increase in PTB risk.
conclusionsCadmium exposure was associated with risk of adverse birth outcomes. Regarding PTB, the formal dose-response meta-analyses suggests a causal association.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.