Association between maternal metal exposure during early pregnancy and intelligence in children aged 3–6 years: Results from a Chinese birth cohort

Maternal environmental metal exposure is common, but long-term prospective epidemiological evidence of its impact on children's intellectual development is still insufficient. Data on maternal plasma metal levels and child intelligence were obtained for 211 3–6-year-old children from Guangxi Zhuang Birth Cohort. ICP-MS was employed to detect 17 metals, including 7 essential metals (Mn, Fe, Co, Ni, Cu, Zn, Mo) and 10 non-essential metals (As, Rb, Sr, Cd, Sb, Cs, Ba, W, Pb, U), in maternal plasma samples obtained before 13 weeks of gestation during the initial maternity checkup. Child intelligence was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition. The GLM, RCS and mixture models were used to assess the associations of maternal plasma metal levels with child intelligence quotient (IQ) scores. The GLM analysis revealed that U had a significant adverse effect on child IQ scores in high-dose exposure groups (−9.236 [-18.644, −4.936], p = 0.006) after adjusting for covariates, while Sb showed a linear adverse effect on children's intelligence in the adjusted model (−4.028 [-7.432, −0.626], p = 0.021). BKMR modeling indicated that overall IQ scores decreased as concentrations of non-essential metals mixtures increased after adjusting for essential metal mixtures, consistent with findings from the WQS (β [95% CI], −8.463 [-14.449, −2.476], p = 0.007) and Qgcomp models (−7.003 [-12.928, −1.078], p = 0.022). Among the non-essential metals, U had the highest negative weight at 37.96%, followed by Pb (23.35%) and Sb (16.91%). Furthermore, potential interactions were observed between metals (Pb and U) and Sb in the study findings. Reducing exposure to non-essential metal mixtures, especially U, Sb and Pb, during early pregnancy and ensuring adequate intake of specific essential metal elements could be a critical intervention in addressing childhood intellectual impairment. [Display omitted] •Early pregnancy single Sb and U exposure was related to childhood IQ.•Non-essential metals mixture exposure in early pregnancy was associated with a risk of childhood IQ decline.•U (37.96%), Pb (23.35%) and Sb (16.91%) were the main contributors to the risk of childhood intelligence.•Essential metals intervene in the detrimental effects of non-essential metal mixtures on children's intelligence.