Trace Minerals, Heavy Metals, and Preeclampsia: Findings from the Boston Birth Cohort

Abstract

BackgroundPreeclampsia is a leading contributor to maternal and perinatal morbidity and mortality. In mice experiments, manganese (Mn) and selenium (Se) are protective whereas cadmium (Cd) is promotive for preeclampsia. Epidemiologic findings on these chemical elements have been inconsistent. To confirm experimental findings in mice, we examined associations of trace minerals (Mn and Se) and heavy metals (Cd, lead [Pb], and mercury [Hg]) with preeclampsia in a birth cohort.Methods and ResultsA total of 1274 women from the Boston Birth Cohort (enrolled since 1998) had complete data on the exposures and outcome. We measured Mn, Se, Cd, Pb, and Hg from red blood cells collected within 24 to 72 hours after delivery. We ascertained preeclampsia diagnosis from medical records. We used Poisson regression with robust variance models to estimate prevalence ratios (PRs) and 95% CIs. A total of 115 (9.0%) women developed preeclampsia. We observed evidence of a dose–response trend for Mn (P for trend<0.001) and to some extent for Cd (P for trend=0.009) quintiles. After multivariable adjustment, a 1 SD increment in Mn was associated with 32% lower risk of developing preeclampsia (PR=0.68; 95% CI, 0.54–0.86), whereas a 1 SD increment in Cd was associated with 15% higher risk of preeclampsia (PR=1.15; 95% CI, 0.98–1.36). Null associations were observed for Se, Pb, and Hg.ConclusionsFindings from our cohort, consistent with evidence from mice experiments and human studies, indicate that women with lower blood concentration of Mn or higher Cd are more likely to develop preeclampsia.

In Utero Exposure to Heavy Metals and Trace Elements and Childhood Blood Pressure in a U.S. Urban, Low-Income, Minority Birth Cohort

“…In adults, some studies suggested that Se and Mn may have protective effects against hypertension and CVD, although there is also evidence of possible adverse effects, nonlinear relationships, or null effects of these elements on BP and CVD (Bulka et al 2019;Laclaustra et al 2009; Lee and Kim 2011; Mordukhovich et al 2012;Nawrot et al 2007;Wu et al 2017). In pregnant women, we reported in the Boston Birth Cohort (Liu et al 2019) and in Project Viva (Liu et al 2020) that higher maternal Mn levels were prospectively associated with lower risk of preeclampsia, a pregnancy complication characterized by high BP and a known risk factor for child high BP (Zhang et al 2020b). It is unclear how in utero exposure to Se and Mn is associated with BP in children.…”

“…Lead (Pb), mercury (Hg), and cadmium (Cd) are highly toxic metals that have no known physiological role but can cause adverse health effects even at trace levels. Exposure to these metals is associated with higher risk of hypertension and CVD in adults (Chowdhury et al 2018;Hu et al 2018;Lanphear et al 2018;Navas-Acien et al 2007;Nawrot et al 2002) and in pregnant women (Kahn and Trasande 2018;Liu et al 2019). The prevalence of exposure to these metals among pregnant women is high.…”

Exposure to toxic metals and per- and polyfluoroalkyl substances and the risk of preeclampsia and preterm birth in the United States: a review

“…In contrast, there are several studies examining the association between cadmium exposure and preeclampsia in the United States. Liu et al 60 measured trace and toxic metals in a cohort of Boston women after delivery and found that each 1 standard deviation increment increase in cadmium in maternal red blood cells was associated with a 15% higher risk of preeclampsia. They also found that each 1 standard deviation increment in manganese was associated with a 32% lower risk of preeclampsia.…”

“…They also found that each 1 standard deviation increment in manganese was associated with a 32% lower risk of preeclampsia. 60 Dawson et al 62 examined cadmium levels in the amniotic fluid from pregnancies complicated by preeclampsia and compared them with normotensive controls. Amniotic fluid cadmium levels were 18% higher in women with preeclampsia than normotensive controls.…”

Patterns and Determinants of Essential and Toxic Elements in Chinese Women at Mid-Pregnancy, Late Pregnancy, and Lactation

“…In addition, maternal exposure to toxic elements, such as mercury, cadmium, and lead, is also concerned [ 3 , 4 ]. In the vulnerable periods of pregnancy and lactation, deficiency and overload of essential trace elements as well as excessive accumulation of toxic elements might co-exist, likely increasing risks of maternal complications [ 5 , 6 ], stillbirth [ 7 ], birth defects [ 8 , 9 ], fetal growth restriction [ 10 , 11 , 12 ], or long-term low neurobehavioral functions [ 13 , 14 , 15 ].…”