ArticleEnvironment international2021
Psychosocial status modifies the effect of maternal blood metal and metalloid concentrations on birth outcomes.
Article in Environment international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- A Systematic Review and Meta-analysis of Chemical Exposures and Attention-Deficit/Hyperactivity Disorder in Children.Prevention science : the official journal of the Society for Prevention Research · 2024Pooled it
- Joint impact of prenatal polycyclic aromatic hydrocarbons, anxiety and depression exposure on birth outcomes across pre-pregnancy BMI categories.Journal of exposure science & environmental epidemiology · 2026Article
- Arsenic, mercury, manganese, and lead exposure in Mexican adults aged 50 and older.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2025Article
- Association of social and environmental exposures at the neighborhood level with child brain volume.Environment international · 2025Article
- Infant cognitive home environment as a moderator for the association of prenatal lead on child language.Neurotoxicology · 2025Article
- Associations Between Ambient PMToxics · 2025Article
- Association of maternal metal exposure and psychological status with adverse pregnancy outcomes: a nested case-control study.Frontiers in public health · 2025Article
- Association of Phenols, Parabens, and Their Mixture with Maternal Blood Pressure Measurements in the PROTECT Cohort.Environmental health perspectives · 2024Article
- Epigenetic Responses to Nonchemical Stressors: Potential Molecular Links to Perinatal Health Outcomes.Current environmental health reports · 2024Review
- Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina.Environmental health : a global access science source · 2023Article
- Article
- Generation of the Chemical and Social Stressors Integration Technique (CASS-IT) to identify areas of holistic public health concern: An application to North Carolina.The Science of the total environment · 2023Article
- Per- and polyfluoroalkyl substances and psychosocial stressors have a joint effect on adverse pregnancy outcomes in the Atlanta African American Maternal-Child cohort.The Science of the total environment · 2023Article
- Adapting to Climate Change: Leveraging Systems-Focused Multidisciplinary Research to Promote Resilience.International journal of environmental research and public health · 2022Review
- Prenatal PFAS and psychosocial stress exposures in relation to fetal growth in two pregnancy cohorts: Applying environmental mixture methods to chemical and non-chemical stressors.Environment international · 2022Article
- Preterm Labor, a Syndrome Attributed to the Combination of External and Internal Factors.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2022Review
- Performance of urine, blood, and integrated metal biomarkers in relation to birth outcomes in a mixture setting.Environmental research · 2021Article
- Prenatal Exposure to Favorable Social and Environmental Neighborhood Conditions Is Associated with Healthy Pregnancy and Infant Outcomes.International journal of environmental research and public health · 2021Article
- Influence of Placental Abnormalities and Pregnancy-Induced Hypertension in Prematurity Associated with Various Assisted Reproductive Technology Techniques.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundMetal exposure and psychosocial stress in pregnancy have each been associated with adverse birth outcomes, including preterm birth and low birth weight, but no study has examined the potential interaction between them.
objectivesWe examined the modifying effect of psychosocial stress on the association between metals and birth outcomes among pregnant women in Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) birth cohort study.
methodsIn our analysis of 682 women from the PROTECT study, we measured 16 essential and non-essential metals in blood samples at two time points. We administered questionnaires to collect information on depression, perceived stress, social support, and life experience during pregnancy. Using K-means clustering, we categorized pregnant women into one of two groups: "good" and "poor" psychosocial status. We then evaluated whether the effect of blood metals (geometric average) on adverse birth outcomes (gestational age, preterm birth [overall and spontaneous], birth weight z-score, small for gestation [SGA], large for gestation [LGA]) vary between two clusters of women, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure.
resultsBlood manganese (Mn) was associated with an increased odds ratio (OR) of overall preterm birth (OR/interquartile range [IQR] = 2.76, 95% confidence interval [CI] = 1.25, 6.12) and spontaneous preterm birth (OR/IQR: 3.68, 95% CI: 1.20, 6.57) only among women with "poor" psychosocial status. The association between copper (Cu) and SGA was also statistically significant only among women having "poor" psychosocial status (OR/IQR: 2.81, 95% CI: 1.20, 6.57). We also observed associations between nickel (Ni) and preterm birth and SGA that were modified by psychosocial status during pregnancy.
conclusionsPresence of "poor" psychosocial status intensified the adverse associations between Mn and preterm birth, Cu and SGA, and protective effects of Ni on preterm. This provides evidence that prenatal psychosocial stress may modify vulnerability to metal exposure.
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