Associations of Maternal Urinary Cadmium with Trimester-Specific Blood Pressure in Pregnancy: Role of Dietary Intake of Micronutrients

Abstract

Previous studies revealed associations of urinary Cd (U-Cd), a chronic Cd exposure biomarker, with blood pressure (BP) in non-pregnant adults. However, the evidence regarding trimester-specific blood pressure in pregnancy and U-Cd and effect modification by dietary intake of micronutrients is scarce. We randomly selected 653 women from the Omega Study cohort. U-Cd was quantified by inductively coupled plasma mass spectrometry. Trimester-specific, systolic (SBP) and diastolic blood pressure (DBP) were determined employing standard protocols and mean arterial pressure (MAP) was also calculated. Associations of SBP, DBP, and MAP with U-Cd tertiles (≤0.21; 0.22-0.41; ≥0.42 μg/g Cr) were assessed using multivariable linear regression models. We also explored effect modification by pre-pregnancy BMI (≤25 or >25 kg/m) or low/high micronutrients intake. After adjusting confounders in women with elevated (upper tertile) as compared with those with low (lowest tertile) U-Cd (≥0.42 vs. ≤0.21 μg/g Cr, respectively) had reduced third trimester MAP (-1.8; 95 % confidence interval (CI) = -3.1, -0.5 mmHg) and second trimester MAP (-1.1; 95 % CI = -2.3, -0.03 mmHg). A significant decrease in third-trimester MAP associated with increased U-Cd was observed only among normal/underweight women (BMI ≤ 25 kg/m) and women with high dietary intake of micronutrients (calcium, magnesium, zinc, and selenium). Notably, U-Cd concentrations increased with the increased consumption of zinc and non-heme iron food sources. No significant differences in U-Cd concentrations were found in preeclamptic women compared with non-preeclamptic women. Our study provides evidence that dietary intake of micronutrients should be taken into account when assessing the health effects of Cd in pregnant women.

Haemodynamic adjustments in third trimester, among pregnant women undergoing antenatal care at a tertiary hospital in Sokoto, Nigeria

“…Assessing the BP indexes, the pregnant group showed lower systolic, diastolic and mean arterial BPs, compared to the nonpregnant control group (P<0.000). This is in consonance with a earlier similar study 24 where BP was reported to drop because of the predominantly systemic vasodilation that occurs in pregnancy, but not other studies, [25][26][27] where no significant changes in BP were observed and there may be an increase in the BP parameters. 15,28 In this regard, the study in Tokyo conducted by Jwa and colleagues, 29 stated the exception to BP fall in mid-pregnancy is only among the category of pregnant women prone to developing pregnancy induced hypertension (PIH).…”

An updated systematic review on the association between Cd exposure, blood pressure and hypertension

“…Inverse associations were found between urine Cd levels and hypertension in four studies ( Garner and Levallois, 2017 ; Noor et al, 2018 ; Vallee et al, 2020 ; Wu et al, 2018 ); the first of these studies found this inverse association in smokers only; and two articles ( Gao et al, 2018 ; Osorio-Yanez et al, 2016 ) found an inverse relationship between urinary Cd and blood pressure.…”

The relationship between cadmium exposure and preeclampsia: A systematic review and meta-analysis

“…The studies that met the inclusion criteria were still limited compared to other heavy metal studies (Zhong, et al 2022), this con ned us from exploring deeper. Furthermore, some studies reported the correlation between Cd and preeclampsia but did not report their data completely, and hence we could not pool them together for further analysis (Kovalchuk, et al 2013;Osorio-Yañez, et al 2016).…”