Abstract

Background:

In utero exposure to heavy metals lead (Pb), mercury (Hg), and cadmium (Cd) may be associated with higher childhood blood pressure (BP), whereas trace elements selenium (Se) and manganese (Mn) may have protective antioxidant effects that modify metal-BP associations.

Objectives:

We examined the individual and joint effects of in utero exposure to Pb, Hg, Cd, Se, and Mn on childhood BP.

Methods:

We used data from the Boston Birth Cohort (enrolled 2002–2013). We measured heavy metals and trace elements in maternal red blood cells collected 24–72 h after delivery. We calculated child BP percentile per the 2017 American Academy of Pediatrics Clinical Practice Guideline. We used linear regression models to estimate the association of each metal, and Bayesian kernel machine regression (BKMR) to examine metal coexposures, with child BP between 3 to 15 years of age.

Results:

Our analytic sample comprised 1,194 mother-infant pairs (61% non-Hispanic Black, 20% Hispanic). Hg and Pb were not associated with child systolic BP (SBP). Se and Mn were inversely associated with child SBP percentiles, which, on average, were 6.23 points lower with a doubling of Se (95% CI: $-11.51$, $-0.96$) and 2.62 points lower with a doubling of Mn (95% CI: $-5.20$, $-0.04$). BKMR models showed similar results. Although Cd was not associated with child SBP overall, the inverse association between Mn and child SBP was stronger at higher levels of Cd ($p\text{-interaction}=0.04$). Consistent with this finding, in utero exposure to cigarette smoke modified the Mn–child SBP association. Among children whose mothers smoked during pregnancy, a doubling of Mn was associated with a 10.09-point reduction in SBP percentile (95% CI: $-18.03$, $-2.15$), compared with a 1.49-point reduction (95% CI: $-4.21$, 1.24) in children whose mothers did not smoke during pregnancy ($p\text{-interaction}=0.08$).

Conclusion:

Se and Mn concentrations in maternal red blood cells collected 24–72 h after delivery were associated with lower child SBP at 3 to 15 years of age. There was an interaction between Mn and Cd on child SBP, whereby the protective association of Mn on child SBP was stronger among mothers who had higher Cd. The association of Mn and child SBP was also modified by maternal cigarette smoking—a source of Cd—during pregnancy. Optimizing in utero Se levels, as well as Mn levels in women who had high Cd or smoked during pregnancy, may protect offspring from developing high BP during childhood. https://doi.org/10.1289/EHP8325

中文翻译：

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美国城市、低收入、少数民族出生队列的子宫内重金属和微量元素暴露与儿童期血压

摘要

背景：

在子宫内接触重金属铅 (Pb)、汞 (Hg) 和镉 (Cd) 可能与较高的儿童血压 (BP) 有关，而微量元素硒 (Se) 和锰 (Mn) 可能具有保护性抗氧化作用修改金属-BP 协会。

目标：

我们检查了子宫内暴露于 Pb、Hg、Cd、Se 和 Mn 对儿童血压的个体和联合影响。

方法：

我们使用了波士顿出生队列（2002-2013 年注册）的数据。我们测量了分娩后 24-72 小时收集的母体红细胞中的重金属和微量元素。我们根据 2017 年美国儿科学会临床实践指南计算儿童血压百分位数。我们使用线性回归模型来估计每种金属的关联，并使用贝叶斯核机器回归 (BKMR) 来检查 3 至 15 岁儿童 BP 的金属共同暴露。

结果：

我们的分析样本包括 1,194 对母婴（61% 非西班牙裔黑人，20% 西班牙裔）。Hg 和 Pb 与儿童收缩压 (SBP) 无关。Se 和 Mn 与儿童 SBP 百分位数呈负相关，Se 加倍时平均降低 6.23 点（95% CI：$-11.51$,$-0.96$) 和 2.62 点随着 Mn 的加倍而降低 (95% CI:$-5.20$,$-0.04$). BKMR 模型显示了类似的结果。尽管 Cd 总体上与儿童 SBP 无关，但在 Cd 水平较高时，Mn 与儿童 SBP 之间的负相关关系更强（$p\text{-相互作用}=0.04$). 与这一发现一致，在子宫内暴露于香烟烟雾改变了锰-儿童 SBP 关联。在母亲怀孕期间吸烟的儿童中，Mn 翻倍与 SBP 百分位数降低 10.09 点相关（95% CI：$-18.03$,$-2.15$)，与减少 1.49 点相比（95% CI：$-4.21$, 1.24) 母亲在怀孕期间不吸烟的儿童 ($p\text{-相互作用}=0.08$).

结论：

分娩后 24-72 小时收集的母体红细胞中的 Se 和 Mn 浓度与 3 至 15 岁时较低的儿童 SBP 相关。Mn 和 Cd 对儿童 SBP 之间存在相互作用，因此在 Cd 较高的母亲中，Mn 对儿童 SBP 的保护作用更强。Mn 和儿童 SBP 的关联也因怀孕期间母亲吸烟（Cd 的来源）而改变。优化子宫内硒水平以及怀孕期间患有高镉或吸烟的女性的锰水平，可以保护后代在儿童时期不会患上高血压。https://doi.org/10.1289/EHP8325