{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T16:37:21Z","timestamp":1781368641247,"version":"3.54.1"},"reference-count":64,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fogarty International Center of the National Institutes of Health","award":["U01TW010087-01"],"award-info":[{"award-number":["U01TW010087-01"]}]},{"name":"Fogarty International Center of the National Institutes of Health","award":["U2RTW010104"],"award-info":[{"award-number":["U2RTW010104"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoX"],"abstract":"<jats:p>Exposure to mercury (Hg) and lead (Pb), in combination with liver and kidney impairment, may result in adverse birth outcomes. From 408 women in the age range of 16 to 46 years, living in rural and urban areas in the interior of Suriname, we looked at the association between adverse birth outcomes and exposure to Hg and Pb in combination with liver and kidney function. This group of women represented a subcohort of pregnant women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH)\u2014Meki Tamara study. Liver function was assessed by measuring aspartate amino transferase (AST), alanine amino transferase (ALT), and gamma-glutamyl transferase (GGT). Kidney function was assessed by measuring creatinine, urea, and cystatin C. We defined preterm births as birth before 37 weeks of gestation, low birthweight as birthweight &lt; 2500 g, and low Apgar score as a score &lt; 7 at 5 min, and these were used as indicators for adverse birth outcomes. Small size for gestational age was defined as gestational age &lt; \u22122SD weight for GA. We found significant statistical associations between biomarkers for liver and kidney functions and adverse birth outcomes Apgar score and gestational age. No significant association was found between heavy metals Hg and lead and adverse birth outcomes.<\/jats:p>","DOI":"10.3390\/jox14030059","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T18:04:59Z","timestamp":1722535499000},"page":"1051-1063","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Association between Liver and Kidney Function and Birth Outcomes in Pregnant Surinamese Women Exposed to Mercury and Lead in the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) Environmental Epidemiologic Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1449-8025","authenticated-orcid":false,"given":"Sheila","family":"Kort","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Anton de Kom University of Suriname, P.O. Box 9212 Paramaribo, Suriname"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-9894","authenticated-orcid":false,"given":"Jeffrey","family":"Wickliffe","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9483-8557","authenticated-orcid":false,"given":"Hannah H.","family":"Covert","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Lichtveld","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4080-3858","authenticated-orcid":false,"given":"Wilco","family":"Zijlmans","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Anton de Kom University of Suriname, P.O. Box 9212 Paramaribo, Suriname"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"ref_1","first-page":"264","article-title":"Environmental Protection Agency Adverse Birth Outcomes","volume":"3","author":"Axelrad","year":"2013","journal-title":"Am. Child. Environ."},{"key":"ref_2","unstructured":"WHO, UNAIDS, UNFPA, UNICEF, UN WOMEN, and The World Bank Group (2018). Survive, Thrive, Transform. Global Strategy for Women\u2019s, Children\u2019s and Adolescents\u2019 Health: 2018 Report on Progress Towards 2030 Targets, World Health Organization."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hassen, T.A., Chojenta, C., Egan, N., and Loxton, D. (2021). The association between the five-minute apgar score and neurodevelopmental outcomes among children aged 8\u221266 months in Australia. Int. J. Environ. Res. 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