ArticleJournal of exposure science & environmental epidemiology2026
Assessing preterm infant metal exposures in shed teeth: findings from the Developmental Impact of NICU Exposures (DINE) study.
Article in Journal of exposure science & environmental epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLimited data exist on environmental exposures experienced by preterm infants in the neonatal intensive care unit (NICU).
objectiveTo determine the timing and magnitude of a broad array of metals during gestation and NICU hospitalization using shed teeth as a biomatrix.
methodsTeeth from participants in the Developmental Impact of NICU Exposures (DINE) cohort were analyzed for Al, As, Ba, Bi, Ca, Cd, Co, Cu, Li, Mg, Mn, Mo, Ni, Pb, Rb, Sn, Sr, and Zn using laser ablation techniques. The neonatal line was used to assign prenatal and postnatal age estimates to metal concentrations relative to Ca in discrete regions of teeth. We evaluated changes in metal ratios across the prenatal/postnatal periods and measurement week using linear mixed effects models and calculated estimated marginal means for each week in the prenatal and postnatal periods.
resultsMetals were measured in 138 participants (median gestational age: 27, IQR 25-28 weeks) and linked to developmental weeks in utero or in the NICU. Averaged differences across the prenatal and postnatal periods decreased for Pb, Ba, Sn, Zn, Mn, Al, Mg, and Cu, and increased for Sr, Rb, and Li. Prenatal ratios were highest and larger than postnatal ratios in weeks 28-30 for Al and Ba. Prenatal Zn was highest in weeks 24 and 30 and Mn was highest during weeks 24 and 25. SIGNIFICANCE: We provide the first comprehensive evaluation of metals during gestation and NICU stay in preterm infants, with postnatal levels generally lower than prenatal levels for most metals. This approach has relevance to ascertaining exposure sources, influences on clinical outcomes, and provides insights not previously possible in cohorts where all third-trimester exposures were incurred in utero. IMPACT: This study represents the first analysis of metals spanning gestation and the NICU stay in a preterm infant population using shed teeth as a biomatrix. Metal levels differentiated across the third trimester prenatally or postnatally in the NICU provide unique insights for understanding exposure sources and health outcomes.
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