Association between gestational levels of toxic metals and essential elements and cerebral palsy in children

Frontiers in Neurology

Neurology

Guro L. Andersen¹  Torstein Vik¹  Cathrine Thomsen²  Helle K. Knutsen²  Helle M. Meltzer²  Kjell Vegard F. Weyde³  Pål Surén³  Thea S. Skogheim³  Gro D. Villanger³  Heidi Aase³  Guido Biele³  Adriano Winterton³  Stephanie M. Engel⁴ 

[1] Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway;Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway;Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway;Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States;

关键词: toxic metal;    essential element;    cerebral palsy (CP);    pregnant women;    brain develeopment;    The Norwegian Mother;    Father;    Child Cohort Study (MoBa);    Medical Birth Registry of Norway (MBRN);   

DOI  :  10.3389/fneur.2023.1124943

 received in 2022-12-16, accepted in 2023-07-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionCerebral palsy (CP) is the most common motor disability in childhood, but its causes are only partly known. Early-life exposure to toxic metals and inadequate or excess amounts of essential elements can adversely affect brain and nervous system development. However, little is still known about these as perinatal risk factors for CP. This study aims to investigate the associations between second trimester maternal blood levels of toxic metals, essential elements, and mixtures thereof, with CP diagnoses in children.MethodsIn a large, population-based prospective birth cohort (The Norwegian Mother, Father, and Child Cohort Study), children with CP diagnoses were identified through The Norwegian Patient Registry and Cerebral Palsy Registry of Norway. One hundred forty-four children with CP and 1,082 controls were included. The relationship between maternal blood concentrations of five toxic metals and six essential elements and CP diagnoses were investigated using mixture approaches: elastic net with stability selection to identify important metals/elements in the mixture in relation to CP; then logistic regressions of the selected metals/elements to estimate odds ratio (OR) of CP and two-way interactions among metals/elements and with child sex and maternal education. Finally, the joint effects of the mixtures on CP diagnoses were estimated using quantile-based g-computation analyses.ResultsThe essential elements manganese and copper, as well as the toxic metal Hg, were the most important in relation to CP. Elevated maternal levels of copper (OR = 1.40) and manganese (OR = 1.20) were associated with increased risk of CP, while Hg levels were, counterintuitively, inversely related to CP. Metal/element interactions that were associated with CP were observed, and that sex and maternal education influenced the relationships between metals/elements and CP. In the joint mixture approach no significant association between the mixture of metals/elements and CP (OR = 1.00, 95% CI = [0.67, 1.50]) was identified.ConclusionUsing mixture approaches, elevated levels of copper and manganese measured in maternal blood during the second trimester could be related to increased risk of CP in children. The inverse associations between maternal Hg and CP could reflect Hg as a marker of maternal fish intake and thus nutrients beneficial for foetal brain development.

【 授权许可】

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Copyright © 2023 Weyde, Winterton, Surén, Andersen, Vik, Biele, Knutsen, Thomsen, Meltzer, Skogheim, Engel, Aase and Villanger.