AUTHOR=Sun Jianhao , Mao Baohong , Wu Zhenzhen , Jiao Xinjuan , Wang Yanxia , Lu Yongli , Ma Xuejing , Liu Xiaohui , Xu Xiaoying , Cui Hongmei , Lin Xiaojuan , Yi Bin , Qiu Jie , Liu Qing 

TITLE=Relationship between maternal exposure to heavy metal titanium and offspring congenital heart defects in Lanzhou, China: A nested case-control study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.946439

DOI=10.3389/fpubh.2022.946439

ISSN=2296-2565

ABSTRACT=Background:Previous studies have found that exposure to heavy metals increased the incidence of congenital heart defects (CHDs). However, data on the relationship between titanium exposure and CHDs are less available. The aim of this study was to analyze the association between prenatal titanium exposure and the risk of CHDs in offspring.
Methods: We retrospectively reviewed a birth cohort study conducted from 2010 to 2012 in our hospital. The associations between titanium exposure and the risk of CHDs were analyzed by using logistic regression analysis to investigate titanium concentrations in maternal whole blood and fetal umbilical cord blood. 
Results: A total of 97 case groups and 194 control groups were included for a nested case-control study. The [P50 (P25 , P75)] of titanium were 371.91 (188.85 , 659.15) μg/L and 370.43 (264.86 , 459.76) μg/L in serum titanium levels in pregnant women and in umbilical cord serum titanium content in the CHDs group, respectively. There was a moderate positive correlation between the concentration of titanium in pregnant women's blood and that in umbilical cord blood. A higher concentrations of maternal blood titanium level was associated with a greater risk of CHDs(OR 2.706, 95% CI 1.547-4.734), The multiple CHDs(OR 2.382, 95% CI 1.219-4.655), atrial septal defects(OR 2.367, 95% CI 1.215-4.609), and patent ductus arteriosus(OR 2.412, 95% CI 1.336-4.357). Dramatically higher concentrations of umbilical cord blood levels had an increased risk of CHDs and different heart defects.
Conclusions: Titanium can cross the placental barrier and the occurrence of CHDs may be related to titanium exposure.