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Birth Defects Res A Clin Mol Teratol. 2016 Feb;106(2):95-103. doi: 10.1002/bdra.23464. Epub 2015 Dec 26.

Association between maternal aluminum exposure and the risk of congenital heart defects in offspring.

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National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Obstetrics & Gynecology, Fujian Provincial Maternal and Child Healthcare Hospital, Fuzhou, Fujian, China.
Department of Ultrasound, Maternal and Child Healthcare Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Department of Ultrasound, Hubei Provincial Maternal and Child Healthcare Hospital, Wuhan, Hubei, China.
Department of Ultrasound, Sichuan Provincial Maternal and Child Healthcare Hospital, Chengdu, Sichuan, China.
Department of Ultrasound, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China.



Aluminum (Al) is the third most common element in the earth' s crust and has been reported to be teratogenic. However, there is lack of understanding about the association between maternal aluminum exposure and the risks of birth defects such as congenital heart defects (CHDs).


A multi-center, hospital-based case-control study was performed at four maternal and child tertiary hospitals in China. A total of 223 cases with CHDs and 223 controls without any abnormalities were recruited according to the inclusion and matching criteria. Hair samples were prepared and measured by inductively coupled plasma mass spectrometry (ICP-MS). The correlation between CHDs and maternal aluminum concentrations was estimated by a 1:1 conditional logistic regression.


The geometric mean and median of hair aluminum levels in isolated or multiple CHD cases was significantly higher than in controls (p < 0.05). A significant association was found between increased hair aluminum concentrations and the risk of total CHDs in offspring (adjusted odds ration [aOR], 2.32; 95% confidence interval [CI], 1.72-3.13), especially in some subtypes of CHDs, such as septal defects (aOR, 2.17; 95% CI, 1.15-4.10), conotruncal defects (aOR, 5.42; 95%CI, 2.43-12.10), and right ventricular outflow track obstruction (aOR, 2.43; 95% CI, 1.08-5.44). However, there was no statistically significant association with left ventricular outflow track obstruction (aOR, 1.66; 95% CI, 0.95-2.88).


A high maternal aluminum concentration may significantly increase the risk of delivering a child with a CHD, such as a septal defect, conotruncal heart defect and right-side obstruction.


aluminum; congenital heart defects; hair biomarker; maternal exposure

[Indexed for MEDLINE]

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