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<p>Congenital heart defects (CHDs) have complex causes, with prenatal exposure to environmental metals emerging as an increasing public health concern due to its potential impact on fetal heart development. Pregnant women are regularly exposed to mixtures of metals. However, few comprehensive studies have examined the joint effects of such exposure on the fetus during the critical window of heart development.&#xa0;To evaluate the association between maternal exposure to both toxic metals (mercury, lead, and arsenic) and essential trace elements (copper, iron, selenium, manganese, and nickel) at everyday or low levels during the periconceptional period and risk for fetal CHDs using individual and mixed approaches.&#xa0;Metal concentrations in maternal hair samples were measured in 170 mothers whose fetuses exhibited CHDs and 170 healthy controls. Logistic regression was used to assess the association between individual metals and CHD risk. The effects of metal mixtures were explored using quantile g-computation and Bayesian kernel machine regression (BKMR). Interactions among mercury, lead, and selenium were also evaluated using both methods.&#xa0;The logistic regression showed that mercury was positively associated with the risk of CHDs, while nickel was inversely associated it. Quantile g-computation identified mercury and nickel as the factors with the strongest positive and negative associations with CHD risk, respectively. BKMR suggested no joint effects of exposure to the eight-metal mixture. No significant interactions were observed.&#xa0;Maternal periconceptional hair concentrations of mercury and nickel are associated with CHD risk, with high mercury and low nickel having detrimental effects. These findings provide a reference for developing intervention strategies to reduce metal exposure and help prevent CHDs.</p>

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Association Between Maternal Exposure to Eight Metals at Everyday or Low Levels During the Periconceptional Period and Risk for Fetal Congenital Heart Defects: A Case-Control Study in China

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Xin Pi,
  • Chunyi Liu,
  • Xiaoqian Jia,
  • Yali Zhang,
  • Jufen Liu,
  • Linlin Wang,
  • Zhiwen Li,
  • Aiguo Ren,
  • Lei Jin

摘要

Congenital heart defects (CHDs) have complex causes, with prenatal exposure to environmental metals emerging as an increasing public health concern due to its potential impact on fetal heart development. Pregnant women are regularly exposed to mixtures of metals. However, few comprehensive studies have examined the joint effects of such exposure on the fetus during the critical window of heart development. To evaluate the association between maternal exposure to both toxic metals (mercury, lead, and arsenic) and essential trace elements (copper, iron, selenium, manganese, and nickel) at everyday or low levels during the periconceptional period and risk for fetal CHDs using individual and mixed approaches. Metal concentrations in maternal hair samples were measured in 170 mothers whose fetuses exhibited CHDs and 170 healthy controls. Logistic regression was used to assess the association between individual metals and CHD risk. The effects of metal mixtures were explored using quantile g-computation and Bayesian kernel machine regression (BKMR). Interactions among mercury, lead, and selenium were also evaluated using both methods. The logistic regression showed that mercury was positively associated with the risk of CHDs, while nickel was inversely associated it. Quantile g-computation identified mercury and nickel as the factors with the strongest positive and negative associations with CHD risk, respectively. BKMR suggested no joint effects of exposure to the eight-metal mixture. No significant interactions were observed. Maternal periconceptional hair concentrations of mercury and nickel are associated with CHD risk, with high mercury and low nickel having detrimental effects. These findings provide a reference for developing intervention strategies to reduce metal exposure and help prevent CHDs.