Prenatal exposure to vanadium and lead and its impact on the risk of congenital heart defects in neonates: evidence from the Lanzhou Birth Cohort

Background Using data from the Lanzhou Birth Cohort in China, this study examined the associations between prenatal exposure to vanadium (V) and lead (Pb)—both individually and jointly—and the risk of neonatal congenital heart defects (CHDs). Methods This birth cohort study, conducted in Lanzhou, China, included 97 mother-newborn pairs assigned to the case group and 194 pairs serving as controls (1:2 ratio). Maternal blood concentrations of V and Pb were quantified using inductively coupled plasma mass spectrometry. Multivariate logistic regression was used to assess associations between prenatal V and Pb exposure levels and the risk of neonatal CHDs and specific subtypes. Interaction effects were further assessed using both additive and multiplicative models. Results Maternal blood V concentrations were positively correlated with Pb levels. Higher maternal blood V levels were significantly associated with an increased risk of CHDs in offspring ( p = 0.005), including isolated CHDs ( p = 0.025), multiple CHDs ( p = 0.013), patent ductus arteriosus (PDA, p = 0.025), and atrial septal defects (ASDs, p = 0.003). Similarly, elevated maternal blood Pb levels were linked to a higher risk of CHDs ( p < 0.001), encompassing isolated CHDs ( p = 0.002), multiple CHDs ( p = 0.002), PDA ( p < 0.001), ASDs ( p = 0.048), and ventricular septal defects (VSDs, p = 0.015). Combined prenatal exposure to elevated V and Pb levels demonstrated a significant association with CHDs risk ( p < 0.001). Conclusions Maternal whole blood levels of V and Pb in late pregnancy, whether considered individually or jointly, were significantly associated with an increased risk of CHDs in the offspring.