This study examined the associations between concentrations of cobalt (Co), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), and zinc (Zn) in placental tissue and risks for NTDs with a case-control design consisting of 408 fetuses or newborns with neural tube defects (NTDs) and 593 non-malformed fetuses or newborns. The concentrations of Zn and Fe were determined by inductively coupled plasma-emission spectrometer and the other four elements by inductively coupled plasma-mass spectrometer. Element concentrations were presented in ng/g or µg/g dry weight of placental tissue. The associations between the levels of each of the six ETEs and risk for NTDs were evaluated using multivariable logistic regression, and the associations between overall levels of all six ETEs and risk for NTDs were examined using Bayesian kernel machine regression (BKMR). Concentrations above the median concentration of all participants for an individual element were associated with increased risk for NTDs: Mn, 3.17-fold (95% CI 2.35-4.28); Mo, 3.73-fold (95% CI 2.74-5.07); Se, 3.28-fold (95% CI 2.44-4.42); and Zn, 2.85-fold (95% CI 2.13-3.83), and a decreased risk for Co [OR, 0.18 (95% CI 0.14-0.25)]. The risk for NTDs increased with the increase in the concentrations of Mn, Mo, Se, and Zn, but decreased for Co, in the second, third, and fourth quartiles, respectively, compared to their lowest quartile (all Pstrend < 0.01). In BKMR model, the risk for NTDs increased constantly when the overall exposure levels were higher than the median of the six ETEs as a co-exposure mixture, and the associations between Co, Mn, Se, and Zn and NTD risk remained when the remaining five elements were taken into consideration simultaneously. Taken together, when evaluated individually, higher levels of Mn, Se, and Zn in placental tissue are associated with increased risk for NTDs, while higher levels of Co are associated with decreased risk for NTDs; when examined collectively, the risk of NTDs increases continuously when exposure levels are higher than the median of the six ETE mixture.

中文翻译：

---

胎盘组织中的必需微量元素和胎儿神经管缺损的风险。

这项研究检查了胎盘组织中钴（Co），铁（Fe），锰（Mn），钼（Mo），硒（Se）和锌（Zn）的浓度与NTD风险的关系该设计包括408例具有神经管缺陷（NTD）的胎儿或新生儿和593例畸形的胎儿或新生儿。Zn和Fe的浓度通过电感耦合等离子体发射光谱仪测定，其他四种元素通过电感耦合等离子体质谱仪测定。元素浓度以胎盘组织的干重ng / g或µg / g表示。使用多变量logistic回归评估了六个ETE的水平与NTD风险之间的关联，使用贝叶斯核仁机器回归（BKMR）检查了所有六个ETE的总体水平与NTD风险之间的关联。单个元素的浓度高于所有参与者的中值浓度与NTD风险增加相关：Mn为3.17倍（95％CI为2.35-4.28）。Mo，3.73倍（95％CI 2.74-5.07）； M + H 2O。Se，3.28倍（95％CI 2.44-4.42）； Es ＝ 3.28倍。和锌，是2.85倍（95％CI 2.13-3.83），而Co的风险降低[OR，0.18（95％CI 0.14-0.25）]。与最低四分位数相比，在第二，第三和第四四分位数中，NTD的风险随着Mn，Mo，Se和Zn浓度的增加而增加，但对于Co降低，其最低四分位数（所有Pstrend <0.01）。在BKMR模型中，当总体暴露水平高于六个作为混合暴露的ETE的中位数时，NTD的风险不断增加，而当采用其余五种元素时，Co，Mn，Se和Zn与NTD风险之间的联系仍然存在同时考虑。综上所述，当单独进行评估时，胎盘组织中较高水平的Mn，Se和Zn与NTD风险增加有关，而较高Co与NTD风险降低有关。共同检查时，当暴露水平高于六种ETE混合物的中位数时，NTD的风险会持续增加。胎盘组织中较高水平的锰，硒和锌与NTD风险增加相关，而较高的Co与NTD风险降低相关；共同检查时，当暴露水平高于六种ETE混合物的中位数时，NTD的风险会持续增加。胎盘组织中较高水平的锰，硒和锌与NTD风险增加相关，而较高的Co与NTD风险降低相关；共同检查时，当暴露水平高于六种ETE混合物的中位数时，NTD的风险会持续增加。