Prenatal exposure to heavy metal mixtures and anthropometric birth outcomes: a cross-sectional study

Tal Michael, Elkana Kohn, Sharon Daniel, Ariela Hazan, Matitiahu Berkovitch, Anna Brik, Ori Hochwald, Liron Borenstein-Levin, Moshe Betser, Miki Moskovich, Ayelet Livne, Rimona Keidar, Efrat Rorman, Luda Groisman, Zeev Weiner, Adi Malkoff Rabin, Ido Solt, Amalia Levy

Research output: Contribution to journalArticlepeer-review


Background: Numerous studies have suggested significant associations between prenatal exposure to heavy metals and newborn anthropometric measures. However, little is known about the effect of various heavy metal mixtures at relatively low concentrations. Hence, this study aimed to investigate associations between prenatal exposures to a wide range of individual heavy metals and heavy metal mixtures with anthropometric measures of newborns. Methods: We recruited 975 mother–term infant pairs from two major hospitals in Israel. Associations between eight heavy metals (arsenic, cadmium, chromium, mercury, nickel, lead, selenium, and thallium) detected in maternal urine samples on the day of delivery with weight, length, and head circumference at birth were estimated using linear and Bayesian kernel machine regression (BKMR) models. Results: Most heavy metals examined in our study were observed in lower concentrations than in other studies, except for selenium. In the linear as well as the BKMR models, birth weight and length were negatively associated with levels of chromium. Birth weight was found to be negatively associated with thallium and positively associated with nickel. Conclusion: By using a large sample size and advanced statistical models, we could examine the association between prenatal exposure to metals in relatively low concentrations and anthropometric measures of newborns. Chromium was suggested to be the most influential metal in the mixture, and its associations with birth weight and length were found negative. Head circumference was neither associated with any of the metals, yet the levels of metals detected in our sample were relatively low. The suggested associations should be further investigated and could shed light on complex biochemical processes involved in intrauterine fetal development.

Original languageEnglish
Article number139
JournalEnvironmental Health: A Global Access Science Source
Issue number1
StatePublished - 1 Dec 2022


  • Anthropometric Measures
  • BKMR
  • Metals
  • Pregnancy
  • Prenatal Exposure

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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