Associations of prenatal Cadmium exposure and offspring cardiovascular structure development

Abstract Objective: The association of maternal heavy metal with childhood cardiovascular structure alterations has not been well established. This study aimed to assess the association of maternal exposure to cadmium (Cd) during early pregnancy with offspring cardiovascular structure in childhood. Methods: A total of 380 mother-children pairs in Shanghai-Birth-Cohort (SBC) were included. Maternal Cd concentration in whole blood was measured in early-pregnancy. Echocardiograghy was done in offspring at 4 years of age. Generalized linear regression models (GLM) adjusted for potential confounders were applied. Mediation analysis was conducted to test the potential mediators. Results: The mean of maternal blood Cd levels were 0.5 ± 0.3 μg/L. After adjusting for potential confounders, GLM models illustrated that higher maternal Cd level was significantly associated with smaller left ventricle diameters and wall thickness of child at the age of 4, including left ventricle diameter in systole(β =-0.784, 95% CI: -1.470, -0.097; P=0.026), interventricular septal thickness at diastole (β =-0.238, 95% CI: -0.429, -0.047; P=0.015), left ventricular mass index (β =-2.003, 95% CI: -3.507,-0.499; P=0.009), end systolic volume (β = -1.519, 95% CI: -2.834,-0.204; P=0.024), and end diastolic volume (β = -3.098, 95% CI: -6.107,-0.088; P=0.044). Mediation analysis showed that child body mass index (BMI) had uncomplete mediation effect in the association of maternal Cd exposure and offsrping cardiovascular structure. Conclusions: These findings suggest that maternal Cd exposure during early pregnancy was adversely associated with children’s cardiovascular structure development including smaller ventricle diameters and wall thickness. And these effects would be mediated by lower offspring BMI.