Placental concentrations of essential, toxic, and understudied metals and relationships with birth outcomes in Chattanooga, TN

Background: Comprehensive examinations of placental metal concentrations and correlations with infant parameters are under-investigated. Chattanooga, Tennessee's consistently high incidence of low birth weight and potential for metal exposure provides an ideal opportunity to investigate potential correlations. Objectives: To investigate the associations between a wide variety of metals in placental tissue and multiple infant parameters. Methods: A total of 31 elements were screened via ICP-MS in 374 individual placental samples. Of those, 14 were quantifiable in > 86% of the samples. We examined correlations between metal concentrations and infant parameters (birth weight, gestational age, birth weight centile, placental weight, birth length and head circumference). We fit multivariable regression models to estimate the covariate-adjusted associations of birth weight with In-transformed concentrations of each of the 14 metals and used generalized additive models to examine nonlinear relationships. Results: Some of the strongest relationships with infant parameters came from several lesser-studied metals. Placental rhodium concentrations were negatively correlated with almost all infant parameters. In the fully adjusted regression model, birth weight was significantly associated with several metals. On an IQR (25th to the 75th percentile) basis, estimated changes in birthweight were: for cobalt (82.5 g, IQR = 6.05 mu g/kg, p = 0.006), iron (-51.5 g, IQR = 171800 mu g/kg, p = 0.030), manganese (-27.2 g, IQR = 152.1 mu g/kg, p = 0.017), lead (-72.7 g, IQR = 16.55 mu g/kg, p = 0.004) and rhodium (-1365.5 g, IQR = 0.33 mu g/kg, p < 0.001). Finally, a generalized additive model showed significant nonlinear relationships between birth weight and concentrations of Co and Rh. Conclusions: Our comprehensive examination of placental metals illustrate many strong associations between lesser-studied metals and infant parameters. These data, in combination with our correlations of well-studied metals, illustrate a need to consider in utero exposure to a broad array of metals when considering fetal development.