ArticleEnvironment international2021
Early pregnancy exposure to metal mixture and birth outcomes - A prospective study in Project Viva.
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 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Association between maternal exposure to mercury during pregnancy and birth weight: a systematic review and meta-analysis.BMC pediatrics · 2026Pooled it
- Prenatal metal(loid) exposure and preterm birth: a systematic review of the epidemiologic evidence.Journal of exposure science & environmental epidemiology · 2025Pooled it
- Developmental manganese exposure, but not concurrent lead, alters social processing selectively in male mice.iScience · 2026Article
- Associations of exposure to cotinine, polycyclic aromatic hydrocarbon, and metal(loid) mixtures during pregnancy with birth weight: the MIEHR study.Journal of exposure science & environmental epidemiology · 2026Article
- Associations between prenatal metal exposure, gene variants, and birth size in Taiwan Birth Panel Study.Pediatric research · 2026Article
- Prenatal exposure to essential and toxic elements in relation to infant growth trajectories.Environmental health : a global access science source · 2026Article
- Maternal mineral nutrition during early pregnancy and neonatal growth: findings from a China birth cohort study.Frontiers in nutrition · 2026Article
- Association between urinary heavy metal concentrations, thyroid hormones, and birth outcomes among pregnant women in Isfahan City.Scientific reports · 2025Article
- Prenatal exposure to metal mixture and birth weight; a Bayesian kernel machine regression analysis of two cohort studies in Japan and Iran.Journal of environmental health science & engineering · 2025Article
- Article
- Using transcriptomic signatures to elucidate individual and mixture effects of inorganic arsenic and manganese in human placental trophoblast HTR-8/SVneo cells.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Association of maternal metal exposure and psychological status with adverse pregnancy outcomes: a nested case-control study.Frontiers in public health · 2025Article
- Cross-Cohort Mixture Analysis: A Data Integration Approach With Applications on Gestational Age and DNA-Methylation-Derived Gestational Age Acceleration Metrics.Biometrical journal. Biometrische Zeitschrift · 2024Article
- Article
- Associations of intrauterine exposure to manganese with fetal and early-childhood growth: a prospective prenatal cohort study.Environmental science and pollution research international · 2024Article
- Update of the risk assessment of inorganic arsenic in food.EFSA journal. European Food Safety Authority · 2024Article
- Associations Between Prenatal Blood Metals and Vitamins and Cord Blood Peptide Hormone Concentrations.Global reproductive health · 2023Article
- Epidemiologic Advances Generated by the Human Health Exposure Analysis Resource Program.Current epidemiology reports · 2023Article
- Metals and per- and polyfluoroalkyl substances mixtures and birth outcomes in the New Hampshire Birth Cohort Study: Beyond single-class mixture approaches.Chemosphere · 2023Article
- Individual, Independent, and Joint Associations of Toxic Metals and Manganese on Hypertensive Disorders of Pregnancy: Results from the MIREC Canadian Pregnancy Cohort.Environmental health perspectives · 2023Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundPrenatal exposure to metals has been individually associated with birth outcomes. However, little is known about the effect of metal mixture, particularly at low exposure levels.
objectivesTo estimate individual and joint effects of metal mixture components on birth outcomes.
methodsWe used data from 1,391 mother-infant pairs in Project Viva (1999-2002). We measured 11 metals in maternal 1st trimester erythrocyte; abstracted birth weight from medical records; calculated gestational age from last menstrual period or ultrasound; and obtained birth length (n = 729) and head circumference (n = 791) from research measurements. We estimated individual and joint effects of metals using multivariable linear and Bayesian kernel machine regressions.
resultsIn both single metal and metal mixture analyses, exposure to higher concentrations of arsenic was associated with lower birth weight in males, zinc with higher head circumference in females, and manganese with higher birth length in sex-combined analysis. We also observed sex-specific metal interactions with birth outcomes. Arsenic and manganese showed a synergistic association with birth weight in males, in whom an interquartile range (IQR) increase in arsenic was associated with 25.3 g (95% CI: -79.9, 29.3), 47.9 g (95% CI: -98.0, 2.1), and 72.2 g (95% CI: -129.8, -14.7) lower birth weight when manganese concentrations were at 25th, 50th, and 75th percentiles, respectively. Lead and zinc showed an antagonistic association with head circumference in males, where an IQR increase in lead was associated with 0.18 cm (95% CI: -0.35, -0.02), 0.10 cm (95% CI: -0.25, 0.04), 0.03 cm (95% CI: -0.2, 0.14) smaller head circumference when zinc concentrations were at 25th, 50th, and 75th percentiles, respectively. Exposure to higher concentrations of arsenic was also associated with lower gestational age in males when concentrations of manganese and lead were higher. DISCUSSION: Maternal erythrocyte concentrations of arsenic, manganese, lead, and zinc were individually and interactively associated with birth outcomes. The associations varied by infant sex and exposure level of other mixture components.
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