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Effects of preterm birth and postnatal exposure to metal mixtures on neurodevelopment in children at 24 months of age

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Abstract

The effects of early-life metal exposure on neurodevelopment in very low birth weight preterm (VLBMP) children (with a birth weight of <1500 g and a gestational age of <37 weeks) have not been clearly established. We aimed to investigate associations of childhood exposure to multiple metals and preterm low birth weight with neurodevelopment among children at 24 months of corrected age. VLBWP children (n = 65) and normal birth weight term (NBWT) children (n = 87) were enrolled from Mackay Memorial Hospital in Taiwan between December 2011 and April 2015. Lead (Pb), cadmium (Cd), arsenic (As), methylmercury (MeHg), and selenium (Se) concentrations in the hair and fingernails were analyzed as biomarkers for metal exposure. The Bayley Scale of Infant and Toddler Development, Third Edition, was used to determine neurodevelopment levels. VLBWP children had significantly lower scores in all development domains compared to NBWT children. We also investigated preliminary exposure levels of VLBWP children to metals as reference values for future epidemiological and clinical survey. Fingernails are a useful biomarker for metal exposure to evaluate the effects on neurological development. A multivariable regression analysis revealed that fingernail Cd concentrations were significantly negatively associated with cognition (β = −0.63, 95% confidence interval (CI): −1.17 to −0.08) and receptive language function (β = −0.43, 95% CI: −0.82 to −0.04) among VLBWP children. VLBWP children with a 10-μg/g increase in the As concentration in their nails had a 8.67-point lower composite score in cognitive ability and a 1.82-point lower score in gross-motor functions. Effects of preterm birth and postnatal exposure to Cd and As were associated with poorer cognitive, receptive language, and gross-motor abilities. VLBWP children are at risk for neurodevelopmental impairments when exposed to metals. Further large-scale studies are needed assess to the risk of neurodevelopmental impairments when vulnerable children are exposed to metal mixtures.

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Abbreviations

As:

arsenic

Bayley-III:

the Bayley Scale of Infant and Toddler Development, Third Edition

Cd:

cadmium

CV:

coefficient of variation

LOD:

limit of detection

MeHg:

methylmercury

NBWT:

normal birth weight term

Pb:

lead

SD:

standard deviation

Se:

selenium

VLBWP:

very low birth weight preterm

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Acknowledgements

The authors express their gratitude to the staff at the Department of Pediatrics, MacKay Children’s Hospital, who were involved in data and sample collection, and all participants in this study for their efforts.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Funding

This work was supported by a grant (TMU102-F-002) from Taipei Medical University.

Author information

Authors and Affiliations

  1. School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan

    Chi-Sian Kao, Yen-Tzu Fan, Ling-Chu Chien & Yi-Jhen Chen

  2. Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan

    Ling-Chu Chien

  3. Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan

    Ling-Chu Chien

  4. School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan

    Kai-Wei Liao

  5. Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan

    Jui-Hsing Chang

  6. Division of Neonatology, Department of Pediatrics, MacKay Children’s Hospital, Taipei, Taiwan

    Jui-Hsing Chang & Chyong-Hsin Hsu

  7. Department of Medicine, MacKay Medical College, New Taipei City, Taiwan

    Jui-Hsing Chang

  8. Premature Baby Foundation of Taiwan, Taipei, Taiwan

    Jui-Hsing Chang & Chyong-Hsin Hsu

  9. Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan

    Chuen-Bin Jiang

  10. Department of Medicine, MacKay Medical College, New Taipei City, Taiwan

    Chuen-Bin Jiang

Authors
  1. Chi-Sian Kao
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Contributions

Chi-Sian Kao—conceptualization, formal analysis, writing—original draft; Yen-Tzu Fan—formal analysis, data validation; Ling-Chu Chien—formal analysis, methodology, funding acquisition; Kai-Wei Liao—formal analysis; investigation; Jui-Hsing Chang—resources, investigation; Chyong-Hsin Hsu—resources, investigation; Yi-Jhen Chen—formal analysis, methodology; Chuen-Bin Jiang—conceptualization, formal analysis, methodology, writing—reviewing and editing.

Corresponding author

Correspondence to Chuen-Bin Jiang.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the institutional review board of Taipei Mackay Memorial Hospital (IRB no. MMH-I-S-596 and IRB no. 13MMHIS088).

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Responsible Editor: Lotfi Aleya

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Kao, CS., Fan, YT., Chien, LC. et al. Effects of preterm birth and postnatal exposure to metal mixtures on neurodevelopment in children at 24 months of age. Environ Sci Pollut Res 30, 86856–86865 (2023). https://doi.org/10.1007/s11356-023-28450-8

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