Prenatal Exposure to Mercury and Adverse Birth Outcomes in Rio de Janeiro, Brazil: Rio Birth Cohort Study (PIPA Project)
DOI:
https://doi.org/10.26911/thejmch.2022.07.05.07Abstract
Background: Mercury (Hg) is a highly toxic environmental pollutant, with studies of its prenatal exposure indicating adverse birth outcomes such as low birth weight, preterm delivery, and micro- cephaly. Therefore, we analyzed prenatal Hg exposure levels and their relationship with birth outcomes in pregnant women living in an urban area in the city of Rio de Janeiro.
Subjects and Method: A cross-sectional study nested in the prospective birth cohort (PIPA Project) was conducted at the Federal University of Rio de Janeiro Maternity School from October to November 2017. A total of 117 mother-infant pairs were evaluated. The sampling technique used convenience sampling. The independent variables encompassed maternal and cord blood Hg levels, while the dependent variables were birth weight, birth length, head circumference (neonatal anthropometrics), and Apgar score at 1 and 5 minutes. The Hg levels were analyzed using induc- tively coupled plasma-mass spectrometry, and dependent variable data were obtained through medical records. Multiple regression models were applied using the SPSS.
Results: The detection rate of maternal and cord blood was 100%, with medians of 0.76 and 0.91 µg/L, respectively. A strong correlation between maternal and cord blood Hg levels was observed (r= 0.70; p<0.010), as well as an inverse association between cord blood Hg and Apgar score at 1 and 5 minutes (b=−0.47; p<0.010; b=−0.34; p<0.010) after adjusting for covariates.
Conclusion: Our study provided preliminary evidence that Hg exposure was associated with a worse Apgar score at 1 and 5 minutes. However, the relevance of this finding requires further evaluations due to its potential clinical implications concerning newborn health.
Keywords: Mercury, Maternal exposure, Apgar Score, Anthropometry
Correspondence: Angelica dos Santos Vianna. Federal University of Rio de Janeiro (UFRJ). Avenida Horacio Macedo sem numero – Proximo a Prefeitura Universitária da UFRJ. Ilha do Fundao – Cidade Universitária. ZIP Code: 21941-598, Rio de Janeiro, RJ, Brazil. Email address: angelica- @iesc.ufrj.br
References
Al-Saleh I, Shinwari N, Mashhour A, Rabahb A (2013). Birth outcome measures and maternal exposure to heavy metals (lead, cadmium and mercury) in Saudi Arabian population. Int. J. Hyg. Environ. Health. 1: 1-14. Doi:10.1016/j.ijheh.2013.04.009.
American College of Obstetricians and Gynecologists (ACOG). The Apgar Score. Committee Opinion Number 644. 2015 Oct. Available at: https://www.acog.org/clinical/clinical-guidance/committee opinion/articles/2015/10/the-apgar-score. (Accessed: 07 April 2022).
Arbuckle TE, Liang CL, Morisset AS, Fisher M, Weiler H, Cirtiu CM, Legrand M et al. (2016). Maternal and fetal expo- sure to cadmium, lead, manganese and mercury: The MIREC study. Chemosphere. 163: 270-282. Doi: 10.10- 16/j.chemosphere.2016.08.023.
Nielsen PIB, Long M, Jorgensen ECB (2019). Pregnant Inuit women exposure to metals and association with fetal growth outcomes: ACCEPT 20- 10-2015. Int. J. Environ. Res. Public Health. 16(1171): 1-27. Doi: 10.3390/ijerph16071171.
O’Reilly SB, McCarthy KM, Steckling N, Lettmeire B (2010). Mercury exposure and children’s health. Curr. Probl. Pediatr. Adolesc. Health Care. 40(8): 186-215. Doi: 10.1016/j.cppeds.2010.07.002.
Callaghan WM, Dietz PM (2010). Differences in Birth Weight for Gestational Age Distributions According to the Measures Used to Assign Gestational Age. Am. J. Epidemiol. 171(7): 826-836. doi.org/10.1093/aje/kwp468.
Channa K, Odland JT, Kootbodien T, Theodorou P, Naik I, Sandanger TM, Rollin HB (2013). Differences in prenatal exposure to mercury in South African communities residing along the Indian Ocean. Sci. Total Environ. 464: 11-19. Doi: 10.1016/j.scitotenv.2013.05.055.
Choi A, Cordier S, Weihe P, Grandjean P (2008). Negative Confounding in the Evaluation of Toxicity: The Case of Methylmercury in Fish and Seafood. Crit. Rev. Toxicol. 38(10): 877–893. Doi: 10.1080/10408440802273164.
Courchia B, Maya LR, John M, Maida G, Jaime H, Daniel R (2018). Congenital poisoning after maternal parenteral mercury administration. J Adv Pediatr Child Health. 1: 1-5. Doi: 10.29328/journal.japch.1001001.
Lopez MEC, Oliveira MA, Araujo AL, Sacramento LS, Takeda PY, Macchi BM, Nascimento JLM et al. (2021). Mercury: What we can learn from the Amazon? Environ. Int. 146: 1-11. Doi: 10.1016/j.envint.2020.106223.
Ding G, Cui C, Chen L, Gao Y, Zhou Y, Shi R, Tian Y (2013). Prenatal low-level mercury exposure and neonatal anthropometry in rural northern China. Chemosphere. 92: 1085-1089. Doi: 10.1016/j.chemosphere.2013.01.045.
Dutra MDS, Cavadas M, Jesus IM, Santos EO, Silva EA, Câmara VM (2012). Limiares auditivos em crianças expostas a mercúrio no período prénatal. J Soc Bras Fonoaudiol. 24(4): 322-326. Doi: 10.1590/S217964912012000400006.
Esquinas EG, Gomez BP, Navarro PF, Fernandez MA, Paz CD, Meixeira AMP, Gil E et al. (2013). Lead, mercury and cadmium in umbilical cord blood and its association with parental epidemiological variables and birth factors. NMC Public Health. 13(841): 1-11. Doi: 10.1186/1471245813841.
Gokoel AR, Wahid FA, Zijlmans WCWR, Shankar A, Mohangoo ADH, Convert hh, Ottevanger MSMD et al. (2020). Influece of prental exposure to mecury, perceived stress, and depression on birth outcomes in Suriname: results from MeKiTamara study. Int. J. Environ. Res. Public Health. 17(12): 4444. Doi: 10.3390/ijerph17124444.
Gundacker C, Frohlich S, Rohrmeister GK, Eibenberger B, Jessenig V, Gicic D, Prinz S et al. (2010). Perinatal lead and mercury exposure in Austria. Sci. Total Environ. 408: 5744–5749. Doi: 10.1016/j.scitotenv.2010.07.079.
Hacon S, Yokoo E, Valente J, Campos RC, Silva VA, Menezes ACC, Moraes LP et al. (2000). Exposure to Mercury in Pregnant Women from Alta Floresta-Amazon Basin, Brazil. Environ. Res. 84(3): 204-210. Doi.org/10.1006/enrs.2000.4115.
Jedrychowski W, Perera F, Rauh V, Flak E, Mróz E, Pac A, Skolicki Z et al. (2007). Fish intake during pregnancy and mercury level in cord and maternal blood at delivery: an environmental study in Poland. Int J Occup Med Environ Health. 20: 31-37. Doi: 10.2478/v1000100700028.
Karagas MR, Choi AL, Oken E, Horvat M, Schoeny R, Kamai E, Cowell W et al. (2012). Evidence on the Human Health Effects of Low-Level Methylmercury Exposure. Environ. Health Perspect. 120(6): 799-806. Doi: 10.1289/ehp.1104494.
Kim BM, Lee BE, Hong YC, Park H, Ha M, Kim YJ, Kim Y et al. (2011). Mercury levels in maternal and cord blood and attained weight through the 24 mon- ths of life. Sci. Total Environ. 410-411: 26-33. Doi: 10.1016/j.scitotenv.2011.08.060.
Kim BM, Choi AL, Ha EHH, Pedersen L, Nielsen F, Weihe P (2014). Effect of hemoglobin adjustment on the precision of mercury concentration in maternal and cord blood. Environ Res. 132: 407-412. Doi: 10.1016/j.envres.2014.04.030.
McLagan DS, Hussain BA, Huang H, Lei YD, Wania F, Mitchell CPJ (2018). Identifying and evaluating urban mercury emission sources through passive sampler-based mapping of atmospheric concentrations. Environ. Res. Lett. 13: 1-10. Doi:10.1088/17489326/aac8e6.
Mendez M, Roman DAP, Laborde A, Noria A, Gil J, Lindner C (2020). Nivel medio de mercurio en mujeres embarazadas y recién nacidos en Uruguay 2016-2018. Rev Salud Ambient. 20(1):1-7.
Frosch RM, Cushing LJ, Jesdale BM, Schwartz JM, Guo W, Guo T, Wang M et al. (2016). Environmental Chemicals in an Urban Population of Pregnant Women and Their Newborns from San Francisco. Environ. Sci. Technol. 50(22): 12464-12472. Doi: 10.1021/acs.est.6b03492.
Patel NB, Xu Y, McCandless LC, Chen LC, Chen A, Yolton K, Braun J et al.(2019). Very low-level prenatal mercury exposure and behaviors in child- ren: the HOME Study. Environ. Health. 18(4): 1-12. Doi: 10.1186/s1294001804435.
Pelroth NH, Branco CWC (2017). Current knowledge of environmental exposure in children during the sensitive developmental periods. J. Pediatr. 93(1): 17-27. Doi: 10.1016/j.jped.2016.07.002.
Pichichero ME, Cernichiari E, Lopreiato J, Treanor J (2002). Mercury concentrations and metabolismo in infants receiving vaccines containing thiomersal: descriptive study. Lancet. 360(9347): 1737-1741. Doi: 10.1016/S01406736(02)116825.
Pinheiro MCN, Carneiro SR, Corbett CEP (2020). Umbilical Cord Tissues as Matrices to Predict Prenatal Exposure to Mercury Review. Ann Pediatr Child Health. 8(7): 1-9.
Pugach S, Clarkson T (2009). Prenatal mercury exposure and postnatal outcome: clinical case report and analysis. Clin. Toxicol. 47: 366-370. Doi: 10.1080/15563650902866911.
Rahbar MH, Vaughan MS, Dickerson AS, Hessabi M, Bressler J, Desai CC, Pellington SS et al. (2015). Concentration of Lead, Mercury, Cadmium, Aluminum, Arsenic and Manganese in Umbilical Cord Blood of Jamaican Newborns. Int. J. Environ. Res. Public Health. 12: 4481-4501. Doi: 10.3390/ijerph120504481.
Ramón R, Ballester F, Aguinagalde X, Amurrio A, Vioque J, Lacasaña M, Rebagliato M (2009). Fish consumption during pregnancy, prenatal mercury exposure, and anthropometric measures at birth in a prospective mother-infant cohort study in Spain. Am J Clin Nutr. 90: 1047–1055. Doi:10.3945/ajcn.2009.27944.
Rollin HF, Rudge CVC, Thomassen Y, Mathee A, Odland J O (2009). Levels of toxic and essential metals in maternal and umbilical cord blood from selected areas of South Africaresults of a pilot study. J. Environ. Monit. 11: 618–627. Doi: 10.1039/b816236k.
Romero M, Saavedra S (2016). The effects of gold mining on newborn’s health. Available at: https://web.stanford.edu/santisap/Paper_mining_newbor n_health.pdf (accessed 03.18.2022).
Sakamoto M, Murata K, Kubota M, Nakai K, Satoh H (2010). Mercury and heavy metal profiles of maternal and umbilical cord RBCs in Japanese population. Ecotoxicol. Environ. Saf. 73: 1-6. Doi: 10.1016/j.ecoenv.2009.09.010.
Santos EO, Jesus IM, Câmara VM, Brabo ES, Jesus MI, Fayal KF, Asmus CIRF (2007). Correlation between blood mercury levels in mothers and newborns in Itaituba, Pará State, Brazil. Cad Saude Publica. 23: S622-629. Doi.org/10.1590/S0102311X2007001 600022.
Song Y, Lee CK, Kim KH, Lee JT, Suh C, Kim SY, Kimm JH et al. (2016). Factors associated with total mercury concentrations in maternal blood, cord blood, and breast milk among pregnant women in Busan, Korea. Asia Pac J Clin Nutr. 25(2): 340-349. Doi: 10.6133/apjcn.2016.25.2.16.
Taylor CM, Golding J, Emond AM (2016). Blood mercury levels and fish consumption in pregnancy: Risks and benefits for birth outcomes in a prospective observational birth co- hort. Int J Hyg Environ Health. 2019(6): 513-520. Doi: 10.1016/j.ijheh.2016.05.004.
Vigeh M, Nishioka E, Ohtani K, Omori Y, Matsukawa T, Kodac S, Yokoyama K (2018). Prenatal mercury exposure and birth weight. Reprod. Toxicol. 76: 78-83. Doi: 10.1016/j.reprotox.2018.01.002.
Won JH, Park JY, Lee TG (2007). Mercury emissions from automobiles using gasoline, diesel, and LPG. Atmos. Environ. 41: 7547–7552. Doi: 10.1016/j.atmosenv.2007.05.043.
World Health Organization - WHO (2007). Exposure to mercury: A major public health concern Geneva: World Health Organization. Available at: https://www.who.int/phe/news/Mercuryflyer.pdf (Accessed 20 March 2022).
Xu Y, Khoury JC, Sucharew H, Dietrich K, Yolton K (2016). Low-level gestational exposure to mercury and maternal fish consumption: Associations with neurobehavior in early infancy. Neurotoxicol. Teratol. 54: 61-67. Doi: 10.1016/j.ntt.2016.02.002.
Yang C, Chen X, Zu S, He F (2019). Retrospective analysis of risk factors for low 1-minute Apgar scores in term neonates. Braz. J. Med. Biol. 52(12): 1-10. Doi: 10.1590/1414431X20199093.
Zhu T, Tang J, Zhao F, Qu Y, Mu D (2015). Association between maternal obesity and offspring Apgar score or cord pH: a systematic review and meta-analysis. Sci. Rep. 5: 18386. Doi: 10.1371/journal.pone.0205733.
