Evidence map›Paper›PMID 33901931›Full record

ArticleEnvironment international2021

Exposure to heavy metals and trace minerals in first trimester and maternal blood pressure change over gestation.

Tiange Liu, Mingyu Zhang, Mohammad L Rahman, Xiaobin Wang, Stefanie N Hinkle, Cuilin Zhang, Noel T Mueller

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Environment international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 44 citations in OpenAlex.

  1. Article
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  4. Investigating the Dual Role of Trace and Toxic Elements in Pregnancy-Related Health Outcomes.International journal of environmental research and public health · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Tiange LiuDepartment of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Mingyu ZhangDepartment of Epidemiology, Johns Hopkins Bloomberg of School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
Mohammad L RahmanDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Xiaobin WangCenter on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Stefanie N HinkleDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Cuilin ZhangDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA. Electronic address: zhangcu@mail.nih.gov.
Noel T MuellerDepartment of Epidemiology, Johns Hopkins Bloomberg of School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA. Electronic address: noeltmueller@jhu.edu.
Johns Hopkins University · USBloomberg (United States) · USHarvard University · USNational Institutes of Health · US

Funding

The National Standard for Normal Fetal GrowthZIAHD008852 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI GRANTZ, KATHERINE · 2009 to 2025
$5.6M
Pathogenesis of Gestational DiabetesZIAHD008887 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI YEUNG, EDWINA · 2009 to 2022
$2.3M
The Effects of Diet on the Gut Microbiome and Short Chain Fatty AcidsK01HL141589 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI MUELLER, NOEL T · 2018 to 2022
$845k
American Heart Association-American Stroke Association 827990NHLBI NIH HHS K01 HL141589NICHD NIH HHS HHSN275200800002INICHD NIH HHS HHSN275200800012CNICHD NIH HHS HHSN275200800013CNICHD NIH HHS HHSN275200800014CNICHD NIH HHS HHSN275200800028CNICHD NIH HHS HHSN275201000009C
6 · The paper itself

Abstract

backgroundWhile several heavy metals and trace minerals have been linked with hypertensive disorders during pregnancy (HDP) in women, no studies have estimated the relationship of exposure to these chemicals, both independently and as a mixture, with systolic blood pressure (SBP) or diastolic blood pressure (DBP) over gestation.

objectivesWe examined individual and joint effects of 1

methodsWe used data from 1832 non-obese pregnant women with low-risk antenatal profiles from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies - Singleton cohort (2009-2013). In plasma collected from women at 8-13 weeks' gestation (baseline enrollment), we measured heavy metals, barium (Ba), cesium (Cs), antimony (Sb), as well as trace minerals, cobalt (Co), copper (Cu), molybdenum (Mo), selenium (Se), and zinc (Zn). We obtained BP at baseline and throughout gestation until delivery and diagnosis of HDP from medical records. We used Bayesian Kernel Machine Regression (BKMR) as well as traditional linear and logistic regressions to examine the cross-sectional associations of chemicals with baseline BP and HDP. We used linear mixed effect regression to examine longitudinal associations between chemicals and rate of weekly change in BP in each trimester. We adjusted for sociodemographic and lifestyle factors and pre-pregnancy body mass index in all models.

resultsBKMR revealed that comparing the entire chemical mixture at the 90

conclusionsIn this multi-ethnic cohort of women with low antenatal risk, plasma metals and trace minerals in early pregnancy, both individually and as a mixture, were statistically significantly associated with BP during gestation in small magnitude and in different directions, but not with HDP. The implications of these findings for women's postpartum BP and future cardiovascular health remains to be investigated.

Indexed as

Metals, HeavyTrace ElementsBayes TheoremBlood PressureChildCross-Sectional StudiesFemaleHumansPregnancyPregnancy Trimester, FirstMetals, HeavyTrace ElementsBayesian kernel machine regressionBlood pressureChemical mixturesHeavy metalsHypertensive disorders during pregnancyTrace minerals

Identifiers

PMID33901931
PMCPMC13138925
OpenAlexW3157362844

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.