Abstract
BACKGROUND: Using data from the Lanzhou Birth Cohort in China, this study examined the associations between prenatal exposure to vanadium (V) and lead (Pb)-both individually and jointly-and the risk of neonatal congenital heart defects (CHDs). METHODS: This birth cohort study, conducted in Lanzhou, China, included 97 mother-newborn pairs assigned to the case group and 194 pairs serving as controls (1:2 ratio). Maternal blood concentrations of V and Pb were quantified using inductively coupled plasma mass spectrometry. Multivariate logistic regression was used to assess associations between prenatal V and Pb exposure levels and the risk of neonatal CHDs and specific subtypes. Interaction effects were further assessed using both additive and multiplicative models. RESULTS: Maternal blood V concentrations were positively correlated with Pb levels. Higher maternal blood V levels were significantly associated with an increased risk of CHDs in offspring (p = 0.005), including isolated CHDs (p = 0.025), multiple CHDs (p = 0.013), patent ductus arteriosus (PDA, p = 0.025), and atrial septal defects (ASDs, p = 0.003). Similarly, elevated maternal blood Pb levels were linked to a higher risk of CHDs (p < 0.001), encompassing isolated CHDs (p = 0.002), multiple CHDs (p = 0.002), PDA (p < 0.001), ASDs (p = 0.048), and ventricular septal defects (VSDs, p = 0.015). Combined prenatal exposure to elevated V and Pb levels demonstrated a significant association with CHDs risk (p < 0.001). CONCLUSIONS: Maternal whole blood levels of V and Pb in late pregnancy, whether considered individually or jointly, were significantly associated with an increased risk of CHDs in the offspring.