Child marriage, maternal serum metal exposure, and risk of preterm birth in rural Bangladesh: evidence from mediation analysis.

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Tytuł:: Child marriage, maternal serum metal exposure, and risk of preterm birth in rural Bangladesh: evidence from mediation analysis.
Autorzy:: Huang H; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
Wei Y; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China. .; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing, China. .
Xia Y; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
Wei L; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing, China.
Chen X; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing, China.
Zhang R; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing, China.
Su L; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Rahman ML; Department of Population Medicine and Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
Rahman M; Dhaka Community Hospital Trust, Dhaka, Bangladesh.
Qamruzzaman Q; Dhaka Community Hospital Trust, Dhaka, Bangladesh.
Guo W; Dhaka Community Hospital Trust, Dhaka, Bangladesh.
Shen H; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.; Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
Hu Z; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.; Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
Christiani DC; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China. .; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. .
Chen F; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China. .; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China. .; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing, China. .
Źródło:: Journal of exposure science & environmental epidemiology [J Expo Sci Environ Epidemiol] 2021 May; Vol. 31 (3), pp. 571-580. Date of Electronic Publication: 2021 Apr 06.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: New York, NY : Nature Pub. Group, c2006-
MeSH Terms:: Premature Birth*/epidemiology
Adolescent ; Bangladesh/epidemiology ; Child ; Female ; Humans ; Infant, Newborn ; Marriage ; Maternal Exposure/adverse effects ; Mediation Analysis ; Pregnancy ; Prospective Studies
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Grant Information:: P30 ES000002 United States ES NIEHS NIH HHS; R01 ES015533 United States ES NIEHS NIH HHS
Contributed Indexing:: Keywords: Child marriage; Inductively coupled plasma mass spectrometry; Metal exposure; Preterm birth
Entry Date(s):: Date Created: 20210407 Date Completed: 20210702 Latest Revision: 20240319
Update Code:: 20240319
PubMed Central ID:: PMC8134042
DOI:: 10.1038/s41370-021-00319-3
PMID:: 33824414
: Czasopismo naukowe

Background: The prevalence of preterm birth in Bangladesh is estimated to be 19.1%, the highest in the world. Although prenatal exposure to several metals has been linked with preterm birth, fewer prospective studies have investigated the socioeconomic factors that affect metal exposure, leading to preterm birth risk.
Objective: We aim to identify novel metal biomarkers and their critical exposure windows, as well as the upstream socioeconomic risk factors for preterm birth in rural Bangladeshi, to shed light for future interventional strategies.
Methods: This study included data from 780 mother-offspring pairs, who were recruited to participate in a prospective birth cohort in Bangladesh (2008-2011). Serum concentrations of 19 metals were measured in the first and second trimesters using inductively coupled plasma mass spectrometry. Mediation analysis was performed to explore the upstream socioeconomic factors that affect the risk of preterm birth mediated via metal exposure concentrations.
Results: Early pregnancy exposure to serum zinc, arsenic, and strontium and mid-pregnancy exposure to barium were significantly associated with risk of preterm birth. Furthermore, younger marriage age was associated with an exponential increase in the risk of preterm birth, and women who married after 18 years old had a considerably lower risk of preterm birth. Mediation analysis indicated that these four elements mediated 30.2% of the effect of marriage age on preterm birth.
Conclusion: This study indicated that maternal serum metal exposure mediates the impact of child marriage on the increased risk of preterm birth via metal exposures. The findings shed light on the mechanisms underlying such association and provide insights into future interventional strategies.

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