Abstract
Cadmium (Cd) is a ubiquitous environmental contaminant, a known carcinogen, and understudied as a developmental toxicant. In the present study, we examined the relationships between Cd levels during pregnancy and infant birth outcomes in a prospective pregnancy cohort in Durham, North Carolina. The study participants (n = 1027) had a mean Cd level of 0.46 µg/L with a range of <0.08 to 2.52 µg/L. Multivariable models were used to establish relationships between blood Cd tertiles and fetal growth parameters, namely birth weight, low birth weight, birth weight percentile by gestational age, small for gestational age, pre-term birth, length, and head circumference. In multivariable models, high maternal blood Cd levels (≥0.50 µg/L) during pregnancy were inversely associated with birth weight percentile by gestational age (p = 0.007) and associated with increased odds of infants being born small for gestational age (p<0.001). These observed effects were independent of cotinine-defined smoking status. The results from this study provide further evidence of health risks associated with early life exposure to Cd among a large pregnancy cohort.
Highlights
Cadmium (Cd) is a heavy metal ubiquitous in the environment and understudied as a developmental toxicant
This study contributes to the growing evidence on the relationship between maternal exposure to Cd during pregnancy and adverse pregnancy outcomes [7,10,33]
Among this large urban and minority cohort of women pregnant women, over 60% have blood Cd levels that exceed the median for US adults as reported in National Health and Nutrition Examination Survey (NHANES) [31]
Summary
Cadmium (Cd) is a heavy metal ubiquitous in the environment and understudied as a developmental toxicant. The largest source of Cd exposure is through tobacco products. One cigarette has been shown to increase the blood Cd level by approximately 0.1– 0.2 mg/L [13]. In the context of smoking, cotinine, the primary metabolite of nicotine and a biomarker of cigarette smoke exposure, has a half-life of less than one day [14,15]. Cotinine is a general measure of recent cigarette exposure. While tobacco products are the largest source of exposure, diet is the most common exposure source. The half-life of Cd in blood can range up to 10 years and may serve as a good reflection of historical exposures [4,13]
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