Barium exposure increases the risk of congenital heart defects occurrence in offspring

Abstract

Context: Several studies have investigated the association between heavy metal exposure and congenital heart defects (CHDs). However, there are limited data regarding the relationship between barium exposure and the occurrence of CHDs. The objective of this study was to analyze the association between barium exposure in mothers and the risk of CHD in offspring.

Materials and methods: We developed a case-control study with 399 cases and 490 controls with normal live births in China. The concentrations of barium in hair of pregnant woman and fetal placenta were measured. We used a logistic regression analysis to explore the association between barium exposure and the risk of CHD.

Results: Logistic regression analysis indicated that the median concentration of barium in maternal hair in the CHD group was 4.180 ng/mg (adjusted odds ratio [aOR], 1.230; 95% confidence interval [CI], 1.146–1.321; p < .001), which was significantly higher than that in the control group (2.740 ng/mg). Furthermore, the median concentration of barium in fetal placental tissue in the CHD group was 0.617 ng/mg, while that in the control group was 0.447 ng/mg (aOR, 1.392; 95% CI, 1.074–1.659; p = .003). Significant differences in the concentration of barium in hair were also found between the different CHD subtypes and the controls. These differences were found in cases with septal defects (p < .001), conotruncal defects (p < .001), right ventricular outflow track obstruction (p < .001), left ventricular outflow track obstruction (p < .001), and anomalous pulmonary venous return (p = .010). Significantly different barium concentrations in fetal tissue were only found in cases with septal defects (p = .010).

Conclusions: Maternal barium exposure was dose-dependently related to the risk of CHD in the offspring. Our findings suggest that the occurrence of some subtypes of CHD is associated with barium exposure.

Keywords:

• Barium
• metal exposure
• congenital heart defect
• hair biomarker
• placenta
• tissue

Ethics approval

The program was approved by the Ethics Committee of Sichuan University (No. 2010004), and informed consent was obtained from all subjects during the enrollment process.

Acknowledgements

We thank all participating families for their cooperation and for providing personal information. We thank the obstetricians, pediatricians, pathologists, experimental technicians, and other participants involved in the project for recruiting the case and control participants and for collecting the data. The design and collection of the study were supported by the National “Twelfth Five-Year” Plan for Science & Technology Support (No. 2014BAI06B01) and Special Foundation for State Basic Research Program of China (No. 2014FY110700). The analysis and interpretation of data and the writing of the manuscript was supported by the National Natural Science Foundation of China ([No. 81573165] and [No.81600157]).

Disclosure statement

The authors declare that they have no competing interests.

Additional information

Funding

The design and collection of the study were supported by the National "Twelfth Five-Year" Plan for Science & Technology Support (No. 2014BAI06B01) and Special Foundation for State Basic Research Program of China (No. 2014FY110700). The analysis and interpretation of data and the writing of the manuscript was supported by the National Natural Science Foundation of China ([No. 81573165] and [No.81600157]).