Association between placental toxic metal exposure and NICU Network Neurobehavioral Scales (NNNS) profiles in the Rhode Island Child Health Study (RICHS)

• Type of Material: Article
• Authors: Pei Wen Tung, Emory University; Amber Burt, Emory University; Margaret Karagas, Geisel School of Medicine at Dartmouth; Brian P Jackson, Dartmouth College; Tracy Punshon, Dartmouth College; Barry Lester, Women & Infants Hospital of Rhode Island; Carmen Marsit, Emory University
• Language: English
• Date: 2021-08-31
• Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.envres.2021.111939
• Title of Journal or Parent Work: ENVIRONMENTAL RESEARCH
• Volume: 204
• Issue: Pt A
• Start Page: 111939
• End Page: 111939
• Keywords: CADMIUM EXPOSURE; PRENATAL LEAD; Lead; NEWBORNS; Environmental Sciences; Life Sciences & Biomedicine; Cadmium; Neurobehavioral assessment; NNNS; Environmental Sciences & Ecology; Science & Technology; LEAD-EXPOSURE; BLOOD LEAD; MOTHERS; MANGANESE EXPOSURE; Placenta; STRESS; Latent profile analysis; ENVIRONMENTAL LEAD; Public, Environmental & Occupational Health; NEURODEVELOPMENT

Abstract

Background: Prenatal exposure to heavy metals has been linked to a variety of adverse outcomes in newborn health and later life. Toxic metals such as cadmium (Cd), manganese (Mn) and lead (Pb) have been implicated to negatively affect newborn neurobehavior. Placental levels of these metals may provide additional understandings on the link between prenatal toxic metal exposures and neurobehavioral performances in newborns. Objective: To evaluate associations between placental concentrations of toxic metals and newborn neurobehavioral performance indicated through the NICU Network Neurobehavioral Scales (NNNS) latent profiles. Method: In the Rhode Island Child Health Study cohort (n = 625), newborn neurobehavioral performance was assessed with NNNS, and a latent profile analysis was used to define five discrete neurobehavioral profiles based on summary scales. Using multinomial logistic regression, we determined whether increased levels of placental toxic metals Cd, Mn and Pb associated with newborns assigned to the profile demonstrating atypical neurobehavioral performances. Results: Every doubling in placenta Cd concentration was associated with increased odds of newborns belonging to the atypical neurobehavior profile (OR: 2.72, 95% CI [1.09, 6.79]). Detectable placental Pb also demonstrated an increased odds of newborns assignment to the atypical profile (OR: 3.71, 95% CI [0.97, 13.96]) compared to being in the typical neurobehavioral profile. Conclusions: Toxic metals Cd and Pb measured in placental tissue may adversely impact newborn neurobehavior. Utilizing the placenta as a prenatal toxic metal exposure biomarker is useful in elucidating the associated impacts of toxic metals on newborn health.