SynthesisJournal of exposure science & environmental epidemiology2025
Prenatal metal(loid) exposure and preterm birth: a systematic review of the epidemiologic evidence.
Synthesis in Journal of exposure science & environmental epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Metal Pollution in the Air and Its Effects on Vulnerable Populations: A Narrative Review.International journal of molecular sciences · 2026Review
- Prenatal exposure to essential and toxic elements in relation to infant growth trajectories.Environmental health : a global access science source · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundPreterm birth (PTB) is a common pregnancy complication associated with significant neonatal morbidity. Prenatal exposure to environmental chemicals, including toxic and/or essential metal(loid)s, may contribute to PTB risk.
objectiveWe aimed to summarize the epidemiologic evidence of the associations among levels of arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), manganese (Mn), lead (Pb), and zinc (Zn) assessed during the prenatal period and PTB or gestational age at delivery; to assess the quality of the literature and strength of evidence for an effect for each metal; and to provide recommendations for future research.
methodsWe adapted the Navigation Guide methodology and followed PRISMA guidelines. We searched the MEDLINE/PubMed database for epidemiologic studies from 1995 to 2023. We used a customized risk of bias protocol and evaluated the sufficiency of evidence for an effect of each metal(loid) on PTB risk.
resultsA total of 1206 studies were identified and screened. Of these, 139 were assessed for eligibility by reading the full-text, and 92 studies were ultimately included (arsenic: 40, cadmium: 30, chromium: 11, copper: 21, mercury: 27, manganese: 17, lead: 41, zinc: 18, metal(loid) mixtures: 12). We found sufficient evidence that lead increases the risk of PTB and, while the evidence was limited, suggestive evidence that cadmium and chromium increase the risk of PTB. The evidence was deemed inadequate to determine an effect for the other metal(loid)s. SIGNIFICANCE: Future research would benefit from more precise PTB clinical phenotyping, measuring exposure early and longitudinally throughout pregnancy, using an appropriate media for metal(loid)s under study, and evaluating metal mixtures. Given the strength of evidence linking lead exposure and PTB, active and comprehensive prenatal screening for lead exposure among pregnant individuals is warranted. IMPACT: By summarizing 92 epidemiologic studies that investigated the associations between metal exposure and preterm birth using the rigorous Navigation Guide methodology, our review provides compelling evidence for a strong link between prenatal lead exposure and preterm birth. Additionally, it suggests potential associations between cadmium and chromium exposure and preterm birth. Given the robust nature of this evidence, there is an urgent need for prenatal screening for lead exposure during pregnancy, along with targeted interventions to reduce exposure. These actions are critical for advancing maternal and child health.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.