Background: Exposure to heavy metals during pregnancy is an important risk factor for adverse birth outcomes. We aimed to investigate the current heavy metal exposure levels in cord blood from healthy pregnant women residing in the Huaihe River Basin, China, and examined the association between heavy metal levels and dietary habits and lifestyle factors. In this study, we measured the exposure levels of five heavy metals in the umbilical cord blood from 350 healthy pregnant women and administered 350 self-reported questionnaires regarding the general characteristics and dietary habits of those women. Methods: This study was undertaken in Shenqiu county, Henan province, which is in the area of the Huai River Basin, in a cohort of pregnant women and newborn babies in 2013–2014. We recruited a sample of 1000 pregnant women among those receiving prenatal examination, measured the real individual newborn exposure to heavy metals in serum by ICP-MS, collected information regarding the pregnant women with a questionnaire survey and obtained data on environmental quality from environmental protection agencies and the available literature. We estimated the daily individual exposure to heavy metals of all the 1000 participants throughout the pregnancy and recorded their birth outcomes after delivery. Then we analyzed the association between birth outcome and individual exposure to heavy metals. Results: 54 newborn children had birth defects. The geometric means of cord blood levels of As, Cd, Cr, Pb and Hg were measured at 0.92 ± 1.01 ng mL–1, 0.11 ± 0.17 ng mL–1, 4.57 ± 5.02 ng mL–1, 3.37 ± 3.81 ng mL–1 and 0.89 ± 1.69 ng mL–1 for subjects (n = 54) who gave birth to infants with birth defects and 0.43 ± 0.88 ng mL–1, 0.52 ± 3.86 ng mL–1, 1.94 ± 2.92 ng mL–1, 4.38 ± 4.96 ng mL–1 and 0.43 ± 0.91 ng mL–1 for subjects (n = 296) with healthy infants, respectively. The contents of all five heavy metals in the whole blood of both of these two groups were higher than the reference values of the Chinese general population (P < 0.001). Conclusions: The occurrence of birth defects was 15.4% in this cohort, and was correlated to exposure of parents to environments containing heavy metal contaminants in Shenqiu county in the Huai River Basin. The heavy metal exposure situation of the investigated population had serious effects in terms of reproductive defects in children. The specific link between newborn defects and environmental heavy metal contaminants suggested that contamination in pregnant women persisted over time, and that the exposure may have a long term effect.
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机译：背景：怀孕期间接触重金属是造成不良分娩结果的重要危险因素。我们旨在调查居住在中国淮河流域的健康孕妇脐带血中当前的重金属暴露水平，并研究重金属水平与饮食习惯和生活方式因素之间的关系。在这项研究中，我们测量了350名健康孕妇的脐带血中五种重金属的暴露水平，并针对这些妇女的一般特征和饮食习惯进行了350份自我报告的问卷调查。方法：本研究于2013-2014年在河南省深丘县进行，该县位于淮河流域地区，在孕妇和新生儿队列中进行。我们从接受产前检查的孕妇中抽取了1000名孕妇的样本，通过ICP-MS测量了新生儿的实际个体在血清中的重金属暴露量，通过问卷调查收集了有关孕妇的信息，并从环境保护机构获得了有关环境质量的数据以及现有文献。我们估算了整个怀孕期间所有1000名参与者的每日个人重金属暴露量，并记录了分娩后的出生结局。然后，我们分析了出生结局与个人重金属暴露之间的关联。结果：54名新生儿患有先天性缺陷。脐血中As，Cd，Cr，Pb和Hg的几何平均值分别为0.92±1.01 ng mL –1 ，0.11±0.17 ng mL –1 ，受试者（n = 54）为4.57±5.02 ng mL –1 ，3.37±3.81 ng mL –1 和0.89±1.69 ng mL –1 ）出生有先天缺陷和0.43±0.88 ng mL –1 ，0.52±3.86 ng mL –1 ，1.94±2.92 ng mL –1的婴儿，健康婴儿受试者（n = 296）分别为4.38±4.96 ng mL –1 和0.43±0.91 ng mL –1 。两组全血中五种重金属的含量均高于中国普通人群的参考值（P <0.001）。结论：该队列中出生缺陷的发生率为15.4％，与父母在淮河流域沉丘县暴露于含有重金属污染物的环境有关。受调查人群的重金属暴露状况对儿童的生殖缺陷有严重影响。新生儿缺陷与环境重金属污染物之间的具体联系表明，孕妇的污染会随着时间的流逝而持续存在，并且暴露可能会产生长期影响。
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