{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:10:21Z","timestamp":1790194221791,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970369"],"award-info":[{"award-number":["81970369"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Congenital heart defects (CHDs) are the most common congenital malformation in the world. Recent studies have found that essential and toxic trace element levels may play a crucial role in the risk of neonatal malformation. However, the relationships between element levels in early pregnancy and CHD risk among humans remain unclear. This study investigates the association between maternal essential element (copper [Cu], zinc [Zn], calcium [Ca], manganese [Mg] and iron [Fe]) and toxic element (lead [Pb] and cadmium [Cd]) levels during early pregnancy and CHDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A hospital\u2010based case\u2013control study was conducted, including 181 cases and 218 controls. Eligible participants underwent antenatal examination during gestational weeks 11\u201314 and trace element levels were detected by the atomic absorption method. Multi\u2010variable logistic regression was used to examine the associations between the level of maternal trace elements and CHD risks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher levels of Ca in early pregnancy were associated with lower risk of ASD\/VSD risks. Moreover, higher Fe, Pb, and Cd levels in the first trimester were associated with higher risks of all CHD and the subtypes risks, and the tests for trend were significant (all <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). The restricted cubic spline analysis showed that there was a nonlinear inverted u\u2010shaped dose\u2013response relationship between levels of Zn, Pb, and Cd in the first trimester and risk of CHDs (non\u2010linearity test <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A moderate increase in Zn and Ca levels and a decrease in Pb and Cd levels during early pregnancy are needed to reduce the incidence of CHDs in the Chinese population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2282","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T07:44:27Z","timestamp":1704786267000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Correlation between essential and toxic elements in maternal blood during early pregnancy and atrial septal defects\/ventricular septal defects\/patent ductus arteriosus in offspring"],"prefix":"10.1002","volume":"116","author":[{"given":"Jianli","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an China"},{"name":"Department of Pharmacy, Xi'an No.3 Hospital The Affiliated Hospital of Northwest University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiqing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Shaanxi Provincial People's Hospital  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaonong","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingxuan","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danli","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Xi'an Hospital of Traditional Chinese Medicine  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Xi'an Jiaotong University Health Science Center  Xi'an 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