First trimester prenatal metal mixtures, vitamins, and hypertensive disorders of pregnancy in the project viva cohort

Ixel Hernandez-Castro; Sheryl L. Rifas-Shiman; Pi-I D. Lin; Jorge E. Chavarro; Diane R. Gold; Mingyu Zhang; Noel T. Mueller; Tamarra James-Todd; Brent Coull; Marie-France Hivert; Emily Oken; Andres Cardenas

Environment International (Aug 2024)

First trimester prenatal metal mixtures, vitamins, and hypertensive disorders of pregnancy in the project viva cohort

Ixel Hernandez-Castro,
Sheryl L. Rifas-Shiman,
Pi-I D. Lin,
Jorge E. Chavarro,
Diane R. Gold,
Mingyu Zhang,
Noel T. Mueller,
Tamarra James-Todd,
Brent Coull,
Marie-France Hivert,
Emily Oken,
Andres Cardenas

Affiliations

Ixel Hernandez-Castro: Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, USA
Sheryl L. Rifas-Shiman: Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
Pi-I D. Lin: Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
Jorge E. Chavarro: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
Diane R. Gold: Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
Mingyu Zhang: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Noel T. Mueller: Department of Epidemiology, Colorado School of Public Health, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
Tamarra James-Todd: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
Brent Coull: Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
Marie-France Hivert: Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA
Emily Oken: Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
Andres Cardenas: Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, USA; Corresponding author at: Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, California 94305, USA.

Journal volume & issue: Vol. 190
p. 108909

Abstract

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Background: Hypertensive disorders of pregnancy (HDP) such as preeclampsia and gestational hypertension are major contributors to maternal and child morbidity and mortality. Previous studies have reported associations with selected metals and vitamins but are limited in sample size and non-prospective study designs. We evaluated prospective associations of metal mixtures with HDP and tested interactions by vitamins. Study Design: We measured first trimester (median = 10.1 weeks) concentrations of essential (copper, magnesium, manganese, selenium, zinc) and nonessential (arsenic, barium, cadmium, cesium, mercury, lead) metals in red blood cells (n = 1,386) and vitamins (B12 and folate) in plasma (n = 924) in Project Viva, a pre-birth US cohort. We collected diagnosis of HDP by reviewing medical records. We used multinomial logistic regression and Bayesian Kernel Machine Regression to estimate individual and joint associations of metals with HDP and interactions by vitamins, after adjusting for key covariates. Results: The majority of participants were non-Hispanic white (72.5 %), never smokers (68.5 %) with a mean (SD) age of 32.3 (4.6) years. Fifty-two (3.8 %) developed preeclampsia and 94 (6.8 %) gestational hypertension. A doubling in first trimester erythrocyte copper was associated with 78 % lower odds of preeclampsia (OR=0.22, 95 % confidence interval: 0.08, 0.60). We also observed significant associations between higher erythrocyte total arsenic and lower odds of preeclampsia (OR=0.80, 95 % CI: 0.66, 0.97) and higher vitamin B12 and increased odds of gestational hypertension (OR=1.79, 95 % CI: 1.09, 2.96), but associations were attenuated after adjustment for dietary factors. Lower levels of the overall metal mixture and essential metal mixture were associated with higher odds of preeclampsia. We found no evidence of interactions by prenatal vitamins or between metals. Conclusion: Lower levels of a first-trimester essential metal mixture were associated with an increased risk of preeclampsia, primarily driven by copper. No associations were observed between other metals and HDP after adjustment for confounders and diet.

Published in Environment International

ISSN: 0160-4120 (Print)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/environment-international

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