Heavy metals exposure levels and their correlation with different clinical forms of fetal growth restriction

Abstract

BackgroundPrenatal heavy metals exposure has shown a negative impact on birth weight. However, their influence on different clinical forms of fetal smallness was never assessed.ObjectivesTo investigate whether there is a differential association between heavy metals exposure and fetal smallness subclassification into intrauterine growth restriction (IUGR) and small-for-gestational age (SGA).MethodIn this prospective case-control study, we included 178 mother–infant pairs; 96 of appropriate for gestational age (AGA) and 82 of small fetuses diagnosed in third trimester. The small ones were further subclassified into IUGR, n = 49 and SGA, n = 33. Cadmium (Cd), mercury (Hg), lead (Pb), arsenic (As) and zinc (Zn) levels were measured in the maternal and cord serum, and in the placentas of the three groups.ResultsMaternal serum level of Cd (p<0.001) was higher in the small fetuses compared to AGA. Fetal serum level of Cd (p<0.001) was increased in the small fetuses compared to AGA. Fetal serum level of Hg (p<0.05) showed an increase in SGA compared to both IUGR and AGA. Fetal serum level of Zn was increased in the AGA (p < 0.001) compared to each of the small fetuses groups. Only differences in the levels between the small fetuses’ subgroups were detected in the fetal serum levels of Cd and Hg. Fetal birth weight was negatively correlated with the fetal serum level of Cd (p < 0.001). No differences in the placental heavy metal levels were observed among the groups.ConclusionFetal serum levels of Cd showed differential correlation between small fetuses' clinical subclassification, which together with the increased Cd levels in both maternal and fetal serum of the small fetuses reinforce the negative influence of heavy metals on birth weight. These findings provide more opportunities to verify the role of heavy metals exposure in relation to small fetuses’ subclassification.

It Takes Time to Unravel the Ecology of War in Gaza, Palestine: Long-Term Changes in Maternal, Newborn and Toddlers’ Heavy Metal Loads, and Infant and Toddler Developmental Milestones in the Aftermath of the 2014 Military Attacks

“…The prevalence of birth-defect babies has increased in Gaza since the start of aerial attacks following the removal of the Israeli occupation army and their settlers in 2005 [ 17 ]; health at birth continued to decrease in the aftermath of the three major military aggressions (2008–2009, 2012 and 2014), registering an increase in preterm births and birth defects associated to heavy metal contamination of pregnant women [ 4 , 8 ] and specific contamination in utero of newborn was documented [ 4 , 55 ]. These data, and the possibility that in utero metal contamination could affect the further development of the infant—as from reports of negative effects of metal assumption on development and neurocognitive functions [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]—according to the DOD (developmental origin of diseases) concept [ 2 ], led to the design of the present investigation.…”

“…Fetal programming refers to the ability of environmental factors during the prenatal development to adjust relevant physiological parameters in the fetus [ 2 ]. Importantly, the adjustments can endure into adulthood, producing non-genetic disorders or dysfunctions and even affect the next generation [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

“…Although knowledge is scarce on prenatal contamination in the context of war, reviews on the impact of industrial and pollution metals confirm that that maternal prenatal exposure to heavy metals predict problems in the course and outcome of pregnancy [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. In particular, lead, cadmium and mercury have been found to predispose pregnancies to complications, such as placental insufficiency [ 31 , 32 ], pre-eclampsia [ 32 ], fetal growth restriction [ 33 , 35 ], and preterm delivery [ 36 , 39 ].…”

Association between blood lead level during pregnancy and birth weight: A meta‐analysis

“…Pregnant women still bear a high health risk from Pb exposure even at currently regarded “safe” levels of Pb exposure of 5 μg/dl for adults 8‐10 . Pb can pass through the placental barrier 7 and cause intrauterine growth restriction, 9,11,12 contributing to low birth weight 12‐14 which is associated with adverse health consequences. In addition to increasing neonatal mortality in the first year of life, low birth weight is associated with lifelong health consequences for infants who survive, such as chronic health conditions and compromised cognitive development 15‐17 …”

Volatile metal emissions from volcanic degassing and lava-seawater interactions at Kīlauea Volcano, Hawai’i

“…the Mediterranean basin 14 ) or countries (Ilyinskaya et al in review), and volcanoes are one of the largest natural sources of many metals 16 . Some trace metals present in volcanic plumes can act as nutrients for living organisms at low levels, yet at higher concentrations are categorised by environmental agencies as pollutants known to be harmful to health 17,18 .…”