{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:36:15Z","timestamp":1792442175033,"version":"4.5.0"},"reference-count":76,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Adverse pregnancy outcomes and their complications cause increased maternal and neonatal morbidity and mortality and contribute considerably to the global burden of disease. In the last two decades, numerous narrative and systematic reviews have emerged assessing non-essential, potentially harmful, trace element exposure as a potential risk factor. This narrative review summarizes the recent literature covering associations between exposure to cadmium, lead, arsenic, and mercury and pregnancy outcomes and highlights common limitations of existing evidence that may hinder decision-making within public health. Several initial scoping searches informed our review, and we searched PubMed (latest date July 2022) for the literature published within the last five years reporting on cadmium, lead, arsenic, or mercury and pre-eclampsia, preterm birth, or prenatal growth. Pre-eclampsia may be associated with cadmium and strongly associated with lead exposure, and exposure to these metals may increase risk of preterm birth. Many reviews have observed cadmium to be negatively associated with birth weight. Additionally, lead and arsenic exposure may be negatively associated with birth weight, with arsenic exposure also adversely affecting birth length and head circumference. These findings should be interpreted with caution due to the limitations of the reviews summarized in this paper, including high heterogeneity due to different exposure assessment methods, study designs, and timing of sampling. Other common limitations were the low quality of the included studies, differences in confounding variables, the low number of studies, and small sample sizes.<\/jats:p>","DOI":"10.3390\/ijerph20085536","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T04:45:32Z","timestamp":1681706732000},"page":"5536","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Effects of Non-Essential \u201cToxic\u201d Trace Elements on Pregnancy Outcomes: A Narrative Overview of Recent Literature Syntheses"],"prefix":"10.3390","volume":"20","author":[{"given":"Maria","family":"Dettwiler","sequence":"first","affiliation":[{"name":"Human Nutrition Laboratory, Institute for Food, Nutrition and Health, ETH Z\u00fcrich, 8092 Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8438-1506","authenticated-orcid":false,"given":"Angela C.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, King\u2019s College London, London SE1 9NH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1005-139X","authenticated-orcid":false,"given":"Jessica","family":"Rigutto-Farebrother","sequence":"additional","affiliation":[{"name":"Human Nutrition Laboratory, Institute for Food, Nutrition and Health, ETH Z\u00fcrich, 8092 Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100308","DOI":"10.1016\/j.ajogmf.2021.100308","article-title":"Exposure to toxic metals and per- and polyfluoroalkyl substances and the risk of preeclampsia and preterm birth in the United States: A review","volume":"3","author":"Stone","year":"2021","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"126468","DOI":"10.1016\/j.jtemb.2020.126468","article-title":"Chemical elements and preeclampsia\u2014An overview of current problems, challenges and significance of recent research","volume":"59","author":"Gajewska","year":"2020","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Khanam, R., Kumar, I., Oladapo-Shittu, O., Twose, C., Islam, A.A., Biswal, S.S., Raqib, R., and Baqui, A.H. (2021). Prenatal Environmental Metal Exposure and Preterm Birth: A Scoping Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18020573"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"McKeating, D.R., Fisher, J.J., and Perkins, A.V. (2019). Elemental Metabolomics and Pregnancy Outcomes. Nutrients, 11.","DOI":"10.3390\/nu11010073"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"60","DOI":"10.2478\/intox-2014-0009","article-title":"Toxicity, mechanism and health effects of some heavy metals","volume":"7","author":"Jaishankar","year":"2014","journal-title":"Interdiscip. Toxicol."},{"key":"ref_6","first-page":"133","article-title":"Heavy metal toxicity and the environment","volume":"101","author":"Tchounwou","year":"2012","journal-title":"Exp. Suppl."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1080\/10937400902902062","article-title":"The effects of metals as endocrine disruptors","volume":"12","author":"Iavicoli","year":"2009","journal-title":"J. Toxicol. Environ. Health B Crit. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.scitotenv.2016.06.134","article-title":"Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy","volume":"569\u2013570","author":"Rahman","year":"2016","journal-title":"Sci. Total. Environ."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/jcb.26234","article-title":"Prevalence of exposure of heavy metals and their impact on health consequences","volume":"119","author":"Rehman","year":"2018","journal-title":"J. Cell. Biochem."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s10354-012-0074-3","article-title":"The role of the placenta in fetal exposure to heavy metals","volume":"162","author":"Gundacker","year":"2012","journal-title":"Wien. Med. Wochenschr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1289\/ehp.1204952","article-title":"Mercury, cadmium, and lead levels in human placenta: A systematic review","volume":"120","author":"Pollan","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_12","unstructured":"Faroon, O., Ashizawa, A., Wright, S., Tucker, P., Jenkins, K., Ingerman, L., and Rudisill, C. (2012). Toxicological Profile for Cadmium, Agency for Toxic Substances and Disease Registry (US)."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s00128-020-03088-1","article-title":"A review on Cadmium Exposure in the Population and Intervention Strategies Against Cadmium Toxicity","volume":"106","author":"Wang","year":"2021","journal-title":"Bull. Environ. Contam. Toxicol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Genchi, G., Sinicropi, M.S., Lauria, G., Carocci, A., and Catalano, A. (2020). The Effects of Cadmium Toxicity. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17113782"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1080\/01480545.2018.1515216","article-title":"Environmental toxic metals in placenta and their effects on preterm delivery-current opinion","volume":"43","author":"Singh","year":"2020","journal-title":"Drug Chem. Toxicol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1007\/s10552-015-0621-5","article-title":"Association of total cancer and lung cancer with environmental exposure to cadmium: The meta-analytical evidence","volume":"26","author":"Nawrot","year":"2015","journal-title":"Cancer Causes Control"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.1007\/s11033-021-07000-w","article-title":"The relationship between oral cancer and cadmium: A review","volume":"49","author":"Satir","year":"2022","journal-title":"Mol. Biol. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1038\/jes.2016.6","article-title":"Cadmium exposure and risk of lung cancer: A meta-analysis of cohort and case-control studies among general and occupational populations","volume":"26","author":"Chen","year":"2016","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"105879","DOI":"10.1016\/j.envint.2020.105879","article-title":"Cadmium exposure and risk of breast cancer: A dose-response meta-analysis of cohort studies","volume":"142","author":"Filippini","year":"2020","journal-title":"Environ. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/978-94-007-5179-8_15","article-title":"Cadmium and cancer","volume":"11","author":"Hartwig","year":"2013","journal-title":"Met. Ions Life Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.toxlet.2022.03.003","article-title":"Cadmium and breast cancer\u2014Current state and research gaps in the underlying mechanisms","volume":"361","author":"Tarhonska","year":"2022","journal-title":"Toxicol. Lett."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S0009-9120(00)00052-7","article-title":"Toxic and essential elements in placentas of swedish women","volume":"33","author":"Osman","year":"2000","journal-title":"Clin. Biochem."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.etap.2019.02.006","article-title":"Cadmium: Toxic effects on placental and embryonic development","volume":"67","author":"Geng","year":"2019","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1002\/jat.1661","article-title":"The effects of metallothionein 2A polymorphism on placental cadmium accumulation: Is metallothionein a modifiying factor in transfer of micronutrients to the fetus?","volume":"32","author":"Tekin","year":"2012","journal-title":"J. Appl. Toxicol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jtemb.2017.10.011","article-title":"Metallothionein 2A gene polymorphism and trace elements in mother-newborn pairs in the Croatian population","volume":"45","author":"Piasek","year":"2018","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_26","unstructured":"Abadin, H., Ashizawa, A., Stevens, Y.W., Llados, F., Diamond, G., Sage, G., Citra, M., Quinones, A., Bosch, S.J., and Swarts, S.G. (2007). Toxicological Profile for Lead, Agency for Toxic Substances and Disease Registry (US)."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/s12940-022-00936-x","article-title":"Relation of blood lead levels and lead in gasoline: An updated systematic review","volume":"21","author":"Angrand","year":"2022","journal-title":"Environ. Health"},{"key":"ref_28","first-page":"435","article-title":"Historical View on Lead: Guidelines and Regulations","volume":"17","author":"Pohl","year":"2017","journal-title":"Met. Ions Life Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.envres.2014.08.036","article-title":"Environmental arsenic, cadmium and lead dust emissions from metal mine operations: Implications for environmental management, monitoring and human health","volume":"135","author":"Taylor","year":"2014","journal-title":"Environ. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"110377","DOI":"10.1016\/j.envres.2020.110377","article-title":"The urban lead (Pb) burden in humans, animals and the natural environment","volume":"193","author":"Levin","year":"2021","journal-title":"Environ. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/occmed\/kqv018","article-title":"Lead toxicity","volume":"65","author":"Gidlow","year":"2015","journal-title":"Occup. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kumar, A., Kumar, A., Cabral-Pinto, M., Chaturvedi, A.K., Shabnam, A.A., Subrahmanyam, G., Mondal, R., Gupta, D.K., Malyan, S.K., and Kumar, S.S. (2020). Lead Toxicity: Health Hazards, Influence on Food Chain, and Sustainable Remediation Approaches. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072179"},{"key":"ref_33","unstructured":"Ettinger, A.S., and Wengrovitz, A.M. (2010). Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women, U.S. Department of Health and Human Services."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1289\/ehp.1510209","article-title":"Arsenic and Environmental Health: State of the Science and Future Research Opportunities","volume":"124","author":"Carlin","year":"2016","journal-title":"Environ. Health Perspect."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s10653-018-0169-x","article-title":"A comprehensive review on current status, mechanism, and possible sources of arsenic contamination in groundwater: A global perspective with prominence of Pakistan scenario","volume":"41","author":"Ali","year":"2019","journal-title":"Environ. Geochem. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1002\/jat.1649","article-title":"Arsenic: Toxicity, oxidative stress and human disease","volume":"31","author":"Jomova","year":"2011","journal-title":"J. Appl. Toxicol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"117940","DOI":"10.1016\/j.envpol.2021.117940","article-title":"Environmental arsenic exposure and its contribution to human diseases, toxicity mechanism and management","volume":"289","author":"Rahaman","year":"2021","journal-title":"Environ. Pollut."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"664717","DOI":"10.3389\/fgene.2021.664717","article-title":"Health Effects Associated With Pre- and Perinatal Exposure to Arsenic","volume":"12","author":"Martinez","year":"2021","journal-title":"Front. Genet."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S826","DOI":"10.1177\/09603271211045955","article-title":"Arsenic exposure and non-carcinogenic health effects","volume":"40","author":"Valenzuela","year":"2021","journal-title":"Hum. Exp. Toxicol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"104539","DOI":"10.1016\/j.yrtph.2019.104539","article-title":"Arsenic exposure: A public health problem leading to several cancers","volume":"110","year":"2020","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1146\/annurev-nutr-080508-141102","article-title":"Effects of arsenic on maternal and fetal health","volume":"29","author":"Vahter","year":"2009","journal-title":"Annu. Rev. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1289\/ehp.02110s111","article-title":"The three modern faces of mercury","volume":"110","author":"Clarkson","year":"2002","journal-title":"Environ. Health Perspect."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"460508","DOI":"10.1155\/2012\/460508","article-title":"Mercury toxicity and treatment: A review of the literature","volume":"2012","author":"Bernhoft","year":"2012","journal-title":"J. Environ. Public Health"},{"key":"ref_44","first-page":"1","article-title":"Mercury toxicity and neurodegenerative effects","volume":"229","author":"Carocci","year":"2014","journal-title":"Rev. Environ. Contam. Toxicol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e00091618","DOI":"10.1590\/0102-311x00091618","article-title":"Human exposure to mercury and its hematological effects: A systematic review","volume":"35","author":"Vianna","year":"2019","journal-title":"Cad. Saude Publica"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/10937401003673750","article-title":"Transport of Inorganic Mercury and Methylmercury in Target Tissues and Organs","volume":"13","author":"Bridges","year":"2010","journal-title":"J. Toxicol. Environ. Health B Crit. Rev."},{"key":"ref_47","unstructured":"American College of Obstetricians and Gynecologists, and Task Force on Hypertension in Pregnancy (2013). Executive Summary: Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists\u2019 Task Force on Hypertension in Pregnancy. Obstet. Gynecol., 122, 1122\u20131131."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/10937404.2018.1554515","article-title":"Environmental contaminants and preeclampsia: A systematic literature review","volume":"21","author":"Rosen","year":"2018","journal-title":"J. Toxicol. Environ. Health B Crit. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1080\/jmf.13.3.157.162","article-title":"Influence of pre-eclampsia on fetal growth","volume":"13","author":"Xiao","year":"2003","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.envres.2017.09.014","article-title":"Blood lead and preeclampsia: A meta-analysis and review of implications","volume":"160","author":"Poropat","year":"2018","journal-title":"Environ. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s11906-018-0888-5","article-title":"Environmental Toxicant Exposure and Hypertensive Disorders of Pregnancy: Recent Findings","volume":"20","author":"Kahn","year":"2018","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"113","DOI":"10.15171\/ijoem.2018.1181","article-title":"Mercury-induced Oxidative Stress May Adversely Affect Pregnancy Outcome among Dental Staff: A Cohort Study","volume":"9","author":"Rezk","year":"2018","journal-title":"Int. J. Occup. Environ. Med."},{"key":"ref_53","unstructured":"Behrman, R.E., and Butler, A.S. (2007). Preterm Birth: Causes, Consequences, and Prevention, National Academies Press (US)."},{"key":"ref_54","unstructured":"(2022, November 20). Preterm Birth. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/preterm-birth."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications","volume":"379","author":"Blencowe","year":"2012","journal-title":"Lancet"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"118264","DOI":"10.1016\/j.envpol.2021.118264","article-title":"Maternal exposure to endocrine disrupting chemicals (EDCs) and preterm birth: A systematic review, meta-analysis, and meta-regression analysis","volume":"292","author":"Wu","year":"2022","journal-title":"Environ. Pollut."},{"key":"ref_57","first-page":"1","article-title":"Births: Final Data for 2020","volume":"70","author":"Osterman","year":"2021","journal-title":"Natl. Vital. Stat. Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1038\/s41370-021-00289-6","article-title":"Cadmium exposure and risk of adverse pregnancy and birth outcomes: A systematic review and dose-response meta-analysis of cohort and cohort-based case-control studies","volume":"31","author":"Amegah","year":"2021","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1080\/09603123.2020.1789947","article-title":"Association between maternal cadmium exposure and preterm birth: A meta-analysis","volume":"32","author":"Asefi","year":"2020","journal-title":"Int. J. Environ. Health Res."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Wai, K.M., Mar, O., Kosaka, S., Umemura, M., and Watanabe, C. (2017). Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14111339"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"105155","DOI":"10.1016\/j.yrtph.2022.105155","article-title":"A scoping review of infant and children health effects associated with cadmium exposure","volume":"131","author":"Flannery","year":"2022","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Milton, A.H., Hussain, S., Akter, S., Rahman, M., Mouly, T.A., and Mitchell, K. (2017). A Review of the Effects of Chronic Arsenic Exposure on Adverse Pregnancy Outcomes. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14060556"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.etap.2019.04.007","article-title":"Association of maternal arsenic exposure with birth size: A systematic review and meta-analysis","volume":"69","author":"Zhong","year":"2019","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s12011-019-01819-y","article-title":"Maternal Exposure to Cadmium and Fetal Growth: A Systematic Review and Meta-Analysis","volume":"195","author":"Khoshhali","year":"2020","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.envpol.2019.05.039","article-title":"The association between prenatal cadmium exposure and birth weight: A systematic review and meta-analysis of available evidence","volume":"251","author":"Huang","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1002\/ajim.23187","article-title":"Association between blood lead level during pregnancy and birth weight: A meta-analysis","volume":"63","author":"Wang","year":"2020","journal-title":"Am. J. Ind. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"107102","DOI":"10.1016\/j.envint.2022.107102","article-title":"Prenatal metal(loid) mixtures and birth weight for gestational age: A pooled analysis of three cohorts participating in the ECHO program","volume":"161","author":"Howe","year":"2022","journal-title":"Environ. Int."},{"key":"ref_68","first-page":"1469","article-title":"The association between maternal cadmium exposure and small for gestational age: A systematic review and meta-analysis","volume":"32","author":"Abyareh","year":"2021","journal-title":"Int. J. Environ. Health Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.jgyn.2013.09.013","article-title":"Pr\u00e9valence, facteurs de risque et morbi-mortalit\u00e9 materno-f\u0153tale des troubles de la croissance f\u0153tale","volume":"42","author":"Gaudineau","year":"2013","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Dack, K., Fell, M., Taylor, C.M., Havdahl, A., and Lewis, S.J. (2021). Mercury and Prenatal Growth: A Systematic Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18137140"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1007\/s00204-015-1515-8","article-title":"Revisiting mobilisation of skeletal lead during pregnancy based on monthly sampling and cord\/maternal blood lead relationships confirm placental transfer of lead","volume":"90","author":"Gulson","year":"2016","journal-title":"Arch. Toxicol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.reprotox.2010.11.002","article-title":"Arsenic methylation efficiency increases during the first trimester of pregnancy independent of folate status","volume":"31","author":"Gardner","year":"2011","journal-title":"Reprod. Toxicol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1093\/jat\/30.2.80","article-title":"Elevated urine arsenic: Un-speciated results lead to unnecessary concern and further evaluations","volume":"30","author":"Kales","year":"2006","journal-title":"J. Anal. Toxicol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Yim, G., Wang, Y., Howe, C.G., and Romano, M.E. (2022). Exposure to Metal Mixtures in Association with Cardiovascular Risk Factors and Outcomes: A Scoping Review. Toxics, 10.","DOI":"10.3390\/toxics10030116"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Laine, J.E., Ray, P., Bodnar, W., Cable, P.H., Boggess, K., Offenbacher, S., and Fry, R.C. (2015). Placental Cadmium Levels Are Associated with Increased Preeclampsia Risk. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0139341"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.toxlet.2009.10.018","article-title":"Accumulation of cadmium in human placenta interacts with the transport of micronutrients to the fetus","volume":"192","author":"Kippler","year":"2010","journal-title":"Toxicol. Lett."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/8\/5536\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:17:12Z","timestamp":1760123832000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/8\/5536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,17]]},"references-count":76,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["ijerph20085536"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20085536","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,17]]}}}