胎盘重金属与妊娠期糖尿病对新生儿体格测量指标的潜在交互作用：一项出生队列研究

Potential interactive effect of placental heavy metals and gestational diabetes mellitus on neonatal anthropometric measures: a birth cohort study

胎盘重金属与妊娠期糖尿病对新生儿体格测量指标的潜在交互作用：一项出生队列研究

Authors: Shidie Chen, Jixing Zhou, Mengjie Zhu, Juan Tong, Chunmei Liang, Xiaoyan Wu, Guopeng Gao, Shuangqin Yan, Fangbiao Tao, Kun Huang

Source:Environmental Pollution

DOI:10.1016/j.envpol.2025.126930

Abstract

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.

摘要

研究表明，胎儿期接触重金属可能影响胎儿生长发育。同时，妊娠期糖尿病（GDM）作为常见的妊娠并发症，也可能对胎儿发育产生影响。鉴于这两种风险因素可能同时存在，有必要进一步研究其对胎儿发育的联合效应。因此，本研究旨在探讨不同母亲GDM状态下，混合金属暴露与新生儿体格测量指标之间的关系。基于马鞍山出生队列（MABC），本研究纳入了2397对母婴。检测了胎盘中的7种金属：砷（As）、钴（Co）、铬（Cr）、铅（Pb）、镉（Cd）、汞（Hg）和锌（Zn）。采用回归模型、权重指数及混合暴露模型分析金属与新生儿体格测量指标的关联性，并进行了相关敏感性分析。在GDM组中，胎盘Zn含量与胎龄小于预期（SGA）风险降低相关（OR = 0.20, 95% CI：0.05-0.83），而Hg与SGA风险增加相关（OR = 3.18，95% CI：1.38-7.35）及胎龄大（LGA）风险增加相关（OR = 2.11，95% CI：1.09-4.12）。我们在非GDM组中观察到混合金属暴露与出生体重之间存在U型关系。而在GDM组中，混合金属暴露浓度的增加与出生体重的增加相关。在非GDM组中, Co暴露与低出生体重（LBW）风险降低相关（OR = 0.13， 95%置信区间：0.04-0.43），而Hg（OR = 2.06，95%置信区间：1.11-3.83）和Cr（OR = 1.87，95%置信区间：1.04-3.35）暴露则与LBW风险增加相关，GDM组未见显著关联。高金属混合浓度与GDM组新生儿出生长度增加相关，但在非GDM组则与出生长度减少相关。胎盘重金属与新生儿体格测量指标之间的关联在GDM组和非GDM组中存在差异。这些观察结果需要进一步的实验研究以阐明其潜在机制。

关键词：妊娠期糖尿病；新生儿体格测量指标；新生儿；体格发育；胎盘金属