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Abstract
Exposure to heavy metals such as lead, cadmium, and mercury poses serious health risks to pregnant women because of their high toxicity. In this study, we investigated the associations of heavy metal exposure with birth outcomes of Korean infants. Data of 5,215 women between 2015 and 2019 were analyzed. This study was part of the Korean Children’s Environmental Health (Ko-CHENS) study. Linear regression and logistic regression analyses were used to examine effects of concentrations of lead, cadmium, and mercury on birth weight, small for gestational age, and large for gestational age after adjusting for maternal age groups, parity, infant sex, education, income, smoking, drinking, body mass index, stillbirth, premature birth, diabetes, hypertension, and gestational diabetes. Besides adjusting for these covariates, each metal was mutually adjusted to estimate birth weight and large for gestational age status. Maternal cadmium concentrations during early pregnancy (β = − 39.96; 95% confidence interval (CI): − 63.76, − 16.17) and late pregnancy (β = − 37.24; 95% CI − 61.63, − 12.84) were significantly associated with birth weight. Cadmium levels during early pregnancy (adjusted OR = 0.637; 95% CI 0.444, 0.912) were also associated with large for gestational age status. Our findings suggest that prenatal cadmium exposure, even at a low level of exposure, is significantly associated with low birth weight.
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1 Kangwon National University, Department of Internal Medicine and Environmental Health Center, School of Medicine, Chuncheon, Republic of Korea (GRID:grid.412010.6) (ISNI:0000 0001 0707 9039)
2 Environmental Health Research Division, National Institute of Environmental Research, Ministry of Environment, Department of Environmental Health Research, Incheon, Republic of Korea (GRID:grid.419585.4) (ISNI:0000 0004 0647 9913)
3 Ministry of Environment, Environmental Health Policy Division, Office of Environmental Health, Sejong, Republic of Korea (GRID:grid.454204.3) (ISNI:0000 0004 0642 3098)
4 Ewha Womans University Medical Center, Department of Pediatrics, Seoul, Republic of Korea (GRID:grid.411076.5)
5 Ewha Womans University, Department of Occupational and Environmental Medicine, School of Medicine, Seoul, Republic of Korea (GRID:grid.255649.9) (ISNI:0000 0001 2171 7754)
6 Ewha Womans University, Department of Medical Science, School of Medicine, Seoul, Republic of Korea (GRID:grid.255649.9) (ISNI:0000 0001 2171 7754)
7 Chonnam National University Hwasun Hospital, Environmental Health Center for Childhood Leukemia and Cancer, and Department of Pediatrics, Hwasun, Republic of Korea (GRID:grid.411602.0) (ISNI:0000 0004 0647 9534)
8 Chonnam National University Hwasun Hospital, Environmental Health Center for Childhood Leukemia and Cancer, and Department of Occupational and Environmental Medicine, Hwasun, Republic of Korea (GRID:grid.411602.0) (ISNI:0000 0004 0647 9534)
9 Chonnam National University Hwasun Hospital, Environmental Health Center for Childhood Leukemia and Cancer, and Department of Laboratory Medicine, Hwasun, Republic of Korea (GRID:grid.411602.0) (ISNI:0000 0004 0647 9534)
10 Dankook University College of Medicine, Department of Psychiatry, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288); Dankook University Medical Center, Environmental Health Center, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288)
11 Dankook University College of Medicine, Department of Preventive Medicine, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288); Dankook University Medical Center, Environmental Health Center, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288)
12 Dankook University, Department of Psychology, College of Public Services, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288); Dankook University Medical Center, Environmental Health Center, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288)
13 Dankook University Medical Center, Environmental Health Center, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288)
14 The Catholic University of Korea, Department of Preventive Medicine, College of Medicine, Seoul, Republic of Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224)
15 Exposure Environmental Health Center, Dong-A University College of Medicine, Department of Preventive Medicine and Heavy Metal, Busan, Republic of Korea (GRID:grid.255166.3) (ISNI:0000 0001 2218 7142)
16 Dong-A University College of Medicine, Department of Pediatrics, Busan, Republic of Korea (GRID:grid.255166.3) (ISNI:0000 0001 2218 7142)
17 Inha University School of Medicine, Department of Pediatrics, Incheon, Republic of Korea (GRID:grid.202119.9) (ISNI:0000 0001 2364 8385); Environmental Health Center for Allergic Diseases, Inha University Hospital, Incheon, Republic of Korea (GRID:grid.411605.7) (ISNI:0000 0004 0648 0025)
18 Environmental Health Center for Allergic Diseases, Inha University Hospital, Incheon, Republic of Korea (GRID:grid.411605.7) (ISNI:0000 0004 0648 0025)
19 The Environmental Health Center, Jeju National University College of Medicine, Jeju, Republic of Korea (GRID:grid.411277.6) (ISNI:0000 0001 0725 5207); Jeju National University College of Medicine, Department of Preventive Medicine, Jeju, Republic of Korea (GRID:grid.411277.6) (ISNI:0000 0001 0725 5207)
20 The Environmental Health Center, Jeju National University College of Medicine, Jeju, Republic of Korea (GRID:grid.411277.6) (ISNI:0000 0001 0725 5207); Jeju National University College of Medicine, Department of Microbiology and Immunology, Jeju, Republic of Korea (GRID:grid.411277.6) (ISNI:0000 0001 0725 5207)
21 Kangwon National University Hospital, Kangwon National University School of Medicine, Department of Obstetrics and Gynecology, Chuncheon, Republic of Korea (GRID:grid.412010.6) (ISNI:0000 0001 0707 9039)
22 Korea University Anam Hospital, Department of Pediatrics, Seoul, Republic of Korea (GRID:grid.411134.2) (ISNI:0000 0004 0474 0479); Korea University Anam Hospital, Environmental Health Center, Seoul, Republic of Korea (GRID:grid.411134.2) (ISNI:0000 0004 0474 0479)
23 Korea University Anam Hospital, Environmental Health Center, Seoul, Republic of Korea (GRID:grid.411134.2) (ISNI:0000 0004 0474 0479)
24 Kosin University Gospel Hospital, Kosin University School of Medicine, Department of Pediatrics, Busan, Republic of Korea (GRID:grid.411145.4) (ISNI:0000 0004 0647 1110)
25 Environmental Health Center for Atopic Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613)
26 Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Pediatrics, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X); Environmental Health Center for Atopic Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613)
27 Seoul National University College of Medicine, Environmental Health Center, Seoul, Republic of Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905); Seoul National University Medical Research Center, Institute of Environmental Medicine, Seoul, Republic of Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905)
28 Seoul National University Hospital, Department of Obstetrics and Gynecology, Seoul, Republic of Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X)
29 Seoul National University Hospital, Department of Pediatrics, Seoul, Republic of Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X)
30 Soonchunhyang University Gumi Hospital, Department of Occupational and Environmental Medicine, Gumi, Republic of Korea (GRID:grid.412484.f)
31 Soonchunhyang University Gumi Hospital, Environmental Health Center, Gumi, Republic of Korea (GRID:grid.412674.2) (ISNI:0000 0004 1773 6524)
32 Daegu Catholic University School of Medicine, Department of Pediatrics, Daegu, Republic of Korea (GRID:grid.412674.2)
33 Daegu Catholic University, Department of Occupational Health, Kyongsan, Republic of Korea (GRID:grid.253755.3) (ISNI:0000 0000 9370 7312)
34 Taean Environmental Health Center, Taean, Republic of Korea (GRID:grid.253755.3)
35 Taean Environmental Health Center, Taean, Republic of Korea (GRID:grid.253755.3); Dankook University College of Medicine, Department of Preventive Medicine, Cheonan, Republic of Korea (GRID:grid.411982.7) (ISNI:0000 0001 0705 4288)
36 Taean Environmental Health Center, Taean, Republic of Korea (GRID:grid.411982.7)
37 University of Ulsan College of Medicine, Environmental Health Center, Ulsan, Republic of Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667)
38 Ulsan University Hospital, University of Ulsan College of Medicine, Department of Occupational and Environmental Medicine, Ulsan, Republic of Korea (GRID:grid.412830.c) (ISNI:0000 0004 0647 7248)