Evidence map›Paper›PMID 41049278›Full record

ArticleGeoHealth2025

Heavy Metal Exposure During Pregnancy and Its Association With Adverse Birth Outcomes: A Cross-Sectional Study.

Tianao Sun, Zhanyue Zheng, Minli Yang, Minglian Pan, Qitao Tan, Yongjie Ma, Yingjie Zhou, Muxue He, Yan Sun

Abstract read
In one paragraph

Article in GeoHealth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
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  3. Review
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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

9 authors.

Tianao SunDepartment of Guilin Medical University Guilin China.
Zhanyue ZhengDepartment of Guilin Medical University Guilin China.
Minli YangDepartment of Guilin Medical University Guilin China.
Minglian PanDepartment of Guilin Medical University Guilin China.
Qitao TanDepartment of Guilin Medical University Guilin China.
Yongjie MaDepartment of Guilin Medical University Guilin China.
Yingjie ZhouDepartment of Guilin Medical University Guilin China.
Muxue HeDepartment of Guilin Medical University Guilin China.
Yan SunDepartment of Guilin Medical University Guilin China.ORCID https://orcid.org/0000-0003-1337-9454

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Prenatal exposure to heavy metals (HMs) has been the focus of international research. However, current studies tend to examine individual metals in isolation and rely on traditional linear regression models, which may not adequately reflect the complex, non-linear and interactive effects of mixed metal exposure. The aim of this study was to investigate the relationship between maternal mixed urinary HM exposure levels during pregnancy and adverse birth outcomes such as preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA) infants using advanced machine learning methods. This study was conducted at a tertiary hospital in Guilin, from 2022 to 2023. A total of 489 pregnant women were enrolled. First-trimester urine samples were collected to quantify HM concentrations using Inductively coupled plasma mass spectrometry. Demographic and clinical data were obtained through structured questionnaires. Bayesian Kernel Machine Regression analysis revealed a significant cumulative effect of mixed metal exposure on adverse pregnancy outcomes, with distinct dose-response relationships. The risk of PTB and LBW increased monotonically with higher exposure levels; the adjusted odds ratios were elevated as metal mixture concentrations increased from the 25th to the 75th percentile. In contrast, the association with SGA exhibited a non-monotonic pattern-higher risk at lower exposure levels and a marked decline in risk at higher concentrations. Inorganic arsenic was identified as the primary toxic component in univariate models. Multivariate response modeling demonstrated the joint influence of metal mixtures on adverse outcomes (AUC = 0.697), with no significant statistical interactions between individual metals, as indicated by parallel dose-response curves (

Indexed as

heavy metallow birth weightpreterm birthsmall for gestational age

Identifiers

PMID41049278
PMCPMC12492349

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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.