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Background: Exposure to toxic trace elements, including heavy metals, is an important public health concern. Few studies have assessed if individual and multiple trace elements simultaneously affect cardiac development. The current study evaluated the association between maternal blood lead (Pb), cadmium (Cd), chromium, copper, mercury, and selenium (Se) levels and congenital heart defects (CHDs) in offspring.
Methods: This hospital-based case-control study included 120 case and 108 control infants. A single maternal peripheral blood draw was made during gestational weeks 17-40 and used to determine trace element levels by inductively couple plasma mass spectrometry. Multivariable logistic regression was used to assess associations and interactions between individual and multiple trace elements and fetal CHDs, adjusted for confounding variables, including maternal age, parity, folic acid intake, cigarette smoking, living in a newly renovated home, maternal BMI, and gestational week at blood sample collection.
Results: In a model including all measured trace elements and adjusted for confounders, maternal Pb (OR=22.60, 95% CI: 5.26, 97.10) and Se (OR=0.26, 95% CI: 0.09, 0.78) were significant predictors of CHDs, and interactions were suggested for CHDs with Pb, Se, and Cd. Similar associations were detected for subgroups of CHDs, including septal and atrioventricular septal defects, conotruncal defects, and right ventricle outflow tract obstruction.
Conclusions: Higher maternal blood Pb and lower maternal blood Se were important dose-dependent predictors of CHDs, overall and for specific groups of lesions. There was suggestive interaction between studied elements. Our results suggest that even under the current standard, Pb exposure poses an important health threat. These data can be used for developing interventions and identifying high risk pregnancies for referral to fetal echocardiography and intensive prenatal monitoring.
Moderated Poster Contributions
Congenital Heart Disease and Pulmonary Hypertension Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-3:55 p.m.
Session Title: Impact of Prenatal Environment on Congenital Heart Disease
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1259M-03
- 2017 American College of Cardiology Foundation