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In Utero Exposure to Metals and Birth Outcomes in an Artisanal and Small-Scale Gold Mining Birth Cohort in Madre de Dios, Peru.

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dc.contributor.author Berky, Axel J.
dc.contributor.author Weinhouse, Caren
dc.contributor.author Vissoci, Joao
dc.contributor.author Rivera, Nelson
dc.contributor.author Ortiz, Ernesto J.
dc.contributor.author Navio, Susy
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Mallipudi, Andres
dc.contributor.author Fixen, Emma
dc.contributor.author Hsu-Kim, Heileen
dc.contributor.author Pan, William K.
dc.coverage.spatial Madre de Dios, Perú
dc.date.accessioned 2023-10-12T15:30:08Z
dc.date.available 2023-10-12T15:30:08Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14283
dc.description.abstract BACKGROUND: Few birth cohorts in South America evaluate the joint effect of minerals and toxic metals on neonatal health. In Madre de Dios, Peru, mercury exposure is prevalent owing to artisanal gold mining, yet its effect on neonatal health is unknown. OBJECTIVES: We aimed to determine whether toxic metals are associated with lower birth weight and shorter gestational age independently of antenatal care and other maternal well-being factors. METHODS: Data are from the COhorte de NAcimiento de MAdre de Dios (CONAMAD) birth cohort, which enrolled pregnant women in Madre de Dios prior to their third trimester and obtained maternal and cord blood samples at birth. We use structural equation models (SEMs) to construct latent variables for the maternal metals environment (ME) and the fetal environment (FE) using concentrations of calcium, iron, selenium, zinc, magnesium, mercury, lead, and arsenic measured in maternal and cord blood, respectively. We then assessed the relationship between the latent variables ME and FE, toxic metals, prenatal visits, hypertension, and their effect on gestational age and birth weight. RESULTS: Among 198 mothers successfully enrolled and followed at birth, 29% had blood mercury levels that exceeded the U.S. Centers for Disease Control and Prevention threshold of 5.8 μg/L and 2 mothers surpassed the former 5-μg/dL threshold for blood lead. The current threshold value is 3.5 μg/dL. Minerals and toxic metals loaded onto ME and FE latent variables. ME was associated with FE (β = 0.24; 95% CI: 0.05, 0.45). FE was associated with longer gestational age (β = 2.31; 95% CI: - 0.3, 4.51) and heavier birth weight. Mercury exposure was not directly associated with health outcomes. A 1% increase in maternal blood lead shortened gestational age by 0.05 d (β =  - 0.75; 95% CI: - 1.51, - 0.13), which at the 5-μg/dL threshold resulted in a loss of 3.6 gestational days and 76.5 g in birth weight for newborns. Prenatal care visits were associated with improved birth outcomes, with a doubling of visits from 6 to 12 associated with 5.5 more gestational days (95% CI: 1.6, 9.4) and 319 g of birth weight (95% CI: 287.6, 350.7). DISCUSSION: Maternal lead, even at low exposures, was associated with shorter gestation and lower birth weight. Studies that focus only on harmful exposures or nutrition may mischaracterize the dynamic maternal ME and FE. SEMs provide a framework to evaluate these complex relationships during pregnancy and reduce overcontrolling that can occur with linear regression. en_US
dc.language.iso eng
dc.publisher Public Health Services, US Dept of Health and Human Services
dc.relation.ispartofseries Environmental Health Perspectives
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Utero Exposure en_US
dc.subject Metals en_US
dc.subject Birth Outcomes en_US
dc.subject Artisanal Gold Mining en_US
dc.subject Small-Scale Gold Mining en_US
dc.subject Birth Cohort en_US
dc.subject Madre de Dios en_US
dc.subject Peru en_US
dc.subject.mesh Útero
dc.subject.mesh Metales
dc.subject.mesh Complicaciones del Embarazo
dc.subject.mesh Minería
dc.subject.mesh Cohorte de Nacimiento
dc.subject.mesh Perú
dc.title In Utero Exposure to Metals and Birth Outcomes in an Artisanal and Small-Scale Gold Mining Birth Cohort in Madre de Dios, Peru. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1289/EHP10557
dc.relation.issn 1552-9924


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