Association between metal cobalt exposure and the risk of congenital heart defect occurrence in offspring: a multi-hospital case-control study

Nannan Zhang,Jiaxiang Yang,Shuihua Yang,Ping Yu,Xinlin Chen,Nana Li,Zhen Liu,Jun Zhu,Ying Deng,Shengli Li

doi:10.1186/s12199-020-00877-2

Abstract

BackgroundMany studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between cobalt exposure and CHD occurrence in offspring. The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring.Materials and methodsIn order to explore the association between cobalt exposure and occurrence of congenital heart defect (CHD), a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of cobalt in hair of pregnant woman and fetal placental tissue were measured and processed by a logistic regression analysis to explore the relationship between cobalt exposure and risk of CHDs.ResultsThe median concentration of hair cobalt in the control and case group was 0.023 ng/mg and 0.033 ng/mg (aOR, 1.837; 95% CI, 1.468–2.299; P < 0.001), respectively. And the median (5–95% range) fetal placental cobalt concentrations were 19.350 ng/g and 42.500 ng/g (aOR, 2.924; 95% CI, 2.211–3.868; P < 0.001) in the control and case groups, respectively. Significant differences in the middle level of cobalt in hair were found in the different CHD subtypes, including septal defects, conotruncal defects, right ventricular outflow tract obstruction, and left ventricular outflow tract obstruction (P < 0.001). Dramatically, different cobalt concentrations in fetal placental tissue were found in all subtypes of cases with CHDs (P < 0.01).ConclusionsThe finding suggested that the occurrence of CHDs may be associated with cobalt exposure.

Highlights

Congenital heart defects (CHDs) have an incidence of 6–8 per 1000 at birth [1] and are the leading cause of perinatal and infant death [2]
The finding suggested that the occurrence of congenital heart defect (CHD) may be associated with cobalt exposure
Fetal placental tissue cobalt exposure and CHD risk As shown in Table 5, the cobalt level in fetal placental tissue increased the risk of CHDs in offspring

Summary

Introduction

Congenital heart defects (CHDs) have an incidence of 6–8 per 1000 at birth [1] and are the leading cause of perinatal and infant death [2]. Many studies have shown that exposure to metals, such as lead, barium, cadmium, arsenic, and copper, increases the risk of CHDs [11, 12]. Anthropogenic use is the main source of cobalt exposure, such as fossil fuel, engine emissions, Co-containing alloys, diamond polishing, and steel [15]. High concentrations of cobalt exposure may be observed in certain occupations, such as hard metal alloy processing and prosthesis use [19]. Inhalation of cobalt dust represents the main source of exposure in occupational workers [20]. Many studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring

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Conclusion