TY - JOUR
T1 - Critical windows for associations between manganese exposure during pregnancy and size at birth
T2 - A longitudinal cohort study in Wuhan, China
AU - Hu, Jie
AU - Wu, Chuansha
AU - Zheng, Tongzhang
AU - Zhang, Bin
AU - Xia, Wei
AU - Peng, Yang
AU - Liu, Wenyu
AU - Jiang, Minmin
AU - Liu, Simin
AU - Buka, Stephen L.
AU - Zhou, Aifen
AU - Zhang, Yiming
AU - Jiang, Yangqian
AU - Hu, Chen
AU - Chen, Xiaomei
AU - Zeng, Qiang
AU - Chen, Xi
AU - Xu, Bing
AU - Zhang, Xichi
AU - Truong, Ashley
AU - Shi, Kunchong
AU - Qian, Zhengmin
AU - Li, Yuanyuan
AU - Xu, Shunqing
N1 - Funding Information:
We thank all the staff and students who made contributions to the cohort study. We thank all the study participants for their support. This work was supported by the National Natural Science Foundation of China (91643207, 91743103, and 21437002), the National Key Research and Development Plan of China (2016YFC0206203 and 2016YFC0206700), and the Fundamental Research Funds for the Central Universities, Huazhong University of Science and Technology (2016YXZD043 and 2018KFYXMPT00).
Publisher Copyright:
© 2019, Public Health Services, US Dept of Health and Human Services. All rights reserved.
PY - 2018/12
Y1 - 2018/12
N2 - BACKGROUND: Prenatal overexposure to manganese (Mn), an essential micronutrient, is related to impaired fetal growth and development. Fetuses appear to be highly sensitive to Mn during short periods of gestation. However, little is known about the critical windows of susceptibility to Mn for humans. OBJECTIVES: Our objective was to estimate trimester-specific associations of exposure to Mn with size at birth. METHODS: Urine samples of 3,022 women were collected repeatedly in the first, second, and third trimesters in Wuhan, China. Urinary concentrations of Mn and other toxic metals were measured using an inductively coupled plasma mass spectrometry. Trimester-specific associations of specific gravity– adjusted urinary Mn concentrations with birth weight, birth length, and ponderal index were estimated using multivariable linear regressions with generalized estimating equations. Linear mixed models were applied to evaluate the windows of susceptibility to Mn exposure by comparing the pattern of Mn exposure among newborns with restricted size at birth to those without. RESULTS: When compared with the third quintile of urinary Mn concentrations, both higher and lower quintiles of urinary Mn concentrations in the second and third trimesters were related to reduced birth weight, birth length, and ponderal index. But the observed associations for higher quintiles were stronger and more likely to be statistically significant [e.g., for women who were in the fifth quintile of Mn concentration in the third trimester, the reduction in birth weight was −11:2 (95% CI: −22:2, −0:1) g and in birth length was −0:04 (95% CI: −0:08, 0.00) cm]. Moreover, newborns with restricted size at birth, compared with those without, had higher levels of Mn exposure in the second and third trimesters. CONCLUSIONS: This prospective prenatal cohort study revealed an association of exposure to Mn during pregnancy, especially late pregnancy, with restricted size at birth. Replications are needed.
AB - BACKGROUND: Prenatal overexposure to manganese (Mn), an essential micronutrient, is related to impaired fetal growth and development. Fetuses appear to be highly sensitive to Mn during short periods of gestation. However, little is known about the critical windows of susceptibility to Mn for humans. OBJECTIVES: Our objective was to estimate trimester-specific associations of exposure to Mn with size at birth. METHODS: Urine samples of 3,022 women were collected repeatedly in the first, second, and third trimesters in Wuhan, China. Urinary concentrations of Mn and other toxic metals were measured using an inductively coupled plasma mass spectrometry. Trimester-specific associations of specific gravity– adjusted urinary Mn concentrations with birth weight, birth length, and ponderal index were estimated using multivariable linear regressions with generalized estimating equations. Linear mixed models were applied to evaluate the windows of susceptibility to Mn exposure by comparing the pattern of Mn exposure among newborns with restricted size at birth to those without. RESULTS: When compared with the third quintile of urinary Mn concentrations, both higher and lower quintiles of urinary Mn concentrations in the second and third trimesters were related to reduced birth weight, birth length, and ponderal index. But the observed associations for higher quintiles were stronger and more likely to be statistically significant [e.g., for women who were in the fifth quintile of Mn concentration in the third trimester, the reduction in birth weight was −11:2 (95% CI: −22:2, −0:1) g and in birth length was −0:04 (95% CI: −0:08, 0.00) cm]. Moreover, newborns with restricted size at birth, compared with those without, had higher levels of Mn exposure in the second and third trimesters. CONCLUSIONS: This prospective prenatal cohort study revealed an association of exposure to Mn during pregnancy, especially late pregnancy, with restricted size at birth. Replications are needed.
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U2 - 10.1289/EHP3423
DO - 10.1289/EHP3423
M3 - Article
C2 - 30675808
AN - SCOPUS:85060391455
VL - 126
JO - Environmental Health Perspectives
JF - Environmental Health Perspectives
SN - 0091-6765
IS - 12
M1 - 127006
ER -
