Abstract:
Pregnant women’s levels of toxic and essential minerals have been linked to birth outcomes yet have not been adequately investigated in South America. In Argentina, n = 696 maternal whole blood samples from Ushuaia (n = 198) and Salta (n = 498) were collected in 2011–2012 among singleton women at 36 12 h postpartum and analyzed for blood concentrations of arsenic (As), cadmium (Cd), mercury (Hg), lead (Pb), copper (Cu), manganese (Mn), selenium (Se) and zinc (Zn). This study examined the associations between maternal elements levels and birth outcomes, and sociodemographic factors contributing to elements levels. Maternal age, parity, body mass index, smoking, and education were linked to concentrations of some but not all elements. In adjusted models, one ln-unit increase in Pb levels was associated with increased gestational age (0.2 weeks, 95% CI = 0.01–0.48) and decreased birth weight (88.90 g, 95% CI = 173.69 to 4.11) and birth length (0.46 cm, 95% CI = 0.85 to 0.08) in the Salta sample. Toxic elements concentrations were not associated with birth outcomes in Ushuaia participants. Birth outcomes are multifactorial problems, and these findings provide a foundation for understanding how the body burden of toxic and essential elements, within the socioeconomic context, may influence birth outcomes.
Description:
SUPPLEMENTARY MATERIAL : FIGURE S1: Directed acyclic graph for gestational age model. FIGURE S2: Directed acyclic graph for birth weight, birth length and head circumference models. FIGURE S3: Directed acyclic graph for preterm birth model. FIGURE S4: Directed acyclic graph for low birth weight model. FIGURE S5: Spearman’s correlation coefficients (r) among the whole blood toxic and essential elements stratified by study sites. FIGURE S6: Spearman’s correlation coefficients (r) between maternal elements concentrations among the overall postpartum women in the EMASAR study. TABLE S1: Descriptive statistics of whole blood elements levels ( g/L) among delivering women in the overall studied population. TABLE S2: Results of multiple linear regression models showing effects of socio-economic determinants in the blood levels of toxic and essential elements. TABLE S3: Multiple linear regression of maternal elements levels and birth outcomes. TABLE S4: Regional-specific multiple linear regression of maternal elements levels and birth outcomes. TABLE S5: Results of logistic regression analyses showing the relationships between tertile of blood elements levels and preterm birth and low birth weight.
