Environ Pollut. 2025 Jul 31. pii: S0269-7491(25)01303-X. [Epub ahead of print]384 126930
Studies demonstrate that prenatal exposure to heavy metals can impair fetal growth and development. Meanwhile, gestational diabetes mellitus (GDM), a frequent pregnancy complication, may also influence fetal development. Given the potential coexistence of these two risk factors, further investigation is needed to elucidate their combined effects on fetal development. Therefore, the current study aims to examine the relationship between mixed metal exposure and neonatal anthropometric measures under different maternal GDM status. Based on the Ma'anshan Birth Cohort (MABC), our study included 2397 mother-child pairs. Seven metals in the placenta were tested: arsenic(As), cobalt(Co), chromium(Cr), lead(Pb), cadmium(Cd), mercury(Hg) and zinc(Zn). Regression models, weighting indices, and mixed exposure models were used to analyze the association of metals and neonatal anthropometric measures, and relevant sensitivity analyses were conducted. In the GDM group, placental Zn was associated with a decreased risk of Small for Gestational Age (SGA) (OR = 0.20, 95 %CI: 0.05-0.83), while Hg was associated with an increased risks of SGA (OR = 3.18, 95 %CI: 1.38-7.35) and Large for Gestational Age (LGA) (OR = 2.11, 95 %CI: 1.09-4.12). We found a U-shaped relationship between mixed metal exposure and birth weight in the non-GDM group. While in the GDM group, an increase in the concentration of mixed metal exposure was associated with an increase in birth weight. In the non-GDM group, a decreased risk of low birth weight(LBW) was observed in Co (OR = 0.13, 95 %CI: 0.04-0.43), while an increased risk was observed in Hg (OR = 2.06, 95 %CI: 1.11-3.83) and Cr (OR = 1.87, 95 %CI: 1.04-3.35) exposure, with no significant associations in GDM. High mixed concentrations were found to be related to increased birth length in GDM group, but related with decreased birth length in non-GDM group. The association between placental heavy metals and neonatal anthropometric measures differed between GDM and non-GDM group. These observations warrant further experimental studies to elucidate the underlying mechanisms.
Keywords: Gestational diabetes mellitus; Neonatal anthropometric measures; Newborn; Physical development; Placental metals