Journal article
Associations of prenatal metal exposures with autism-related outcomes in the ECHO cohort
Environmental epidemiology, v 10(4), e500
Aug 2026
PMID: 42488194
Featured in Collection : Drexel's Newest Publications
Abstract
Background:
Metal exposures adversely impact prenatal neurodevelopment; however, their associations with child autism spectrum disorder (ASD) remain unclear.
Methods:
In the Environmental Influences on Child Health Outcomes Cohort, we analyzed prenatal blood (N = 479) and urinary (N = 482) metal concentrations in relation to Social Responsiveness Scale-Second Edition (SRS-2) total T-scores, SRS-2 subscale T-scores, and ASD diagnosis. Associations were examined using linear and logistic regression for individual metals and Bayesian Kernel Machine Regression for mixtures, adjusting for covariates.
Results:
Interquartile range increases in maternal blood lead and mercury were associated with higher SRS-2 total T-scores (lead: β = 0.11, 95% confidence interval [CI] = 0.03, 0.18; mercury: β = 0.19, 95% CI = 0.01, 0.37), and maternal blood cadmium was associated with higher odds of ASD diagnosis (OR = 2.42, 95% CI = 1.16, 5.03). Bayesian Kernel Machine Regression revealed joint effects of blood metal mixtures (arsenic, cadmium, mercury, and lead) on social awareness and cognition. Blood cadmium correlated with social awareness in females (raw score: β = 0.85, 95% CI = 0.09, 1.61) versus males (p-interaction = 0.02). Urinary barium correlated with social motivation in females (raw score: β = 0.273, 95% CI = 0.067, 0.478) versus males (p-interaction = 0.05).
Conclusions:
Future research should prioritize metal speciation, larger samples, and mechanistic studies to clarify sex-specific pathways.
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Details
- Title
- Associations of prenatal metal exposures with autism-related outcomes in the ECHO cohort
- Creators
- Pi-I Debby Lin - Harvard Pilgrim Health CareAndres Cardenas - Stanford UniversityKristen Lyall - Drexel UniversityDeborah Bilder - University of UtahDebra A. Mackenzie - University of New MexicoSara Nozadi - University of New MexicoBrandon J. Rennie - University of New MexicoRebecca Schmidt - University of California, DavisHeather Volk - Johns Hopkins UniversityAisha S. Dickerson - Johns Hopkins UniversityEmily Oken - Harvard University
- Publication Details
- Environmental epidemiology, v 10(4), e500
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 10
- Grant note
- Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health: U2COD023375, U24OD023382, U24OD023319 Office of Behavioral and Social Science Research: U24OD035523, ES0266542, U24ES026539, U2CES026533, U2CES026542, U2CES030859, U2CES030857, U2CES026555, U2CES026561, U2CES030851, UG3/UH3OD023251, UH3OD023320, UG3OD035546, UH3OD023332, UG3/UH3OD023253, UG3/UH3OD023248, UG3OD035526, UG3/UH3OD023313, UH3OD023328, UH3OD023318, UG3/UH3OD023279, UG3/UH3OD023289, UG3/UH3OD023282, UH3OD023287, UG3/UH3OD023365, UG3/UH3OD023244, UG3/UH3OD023275, UH3OD023271, UG3OD035528, UH3OD023347, UG3/UH3OD023389, UG3/UH3OD023344, UH3OD023268, UG3/UH3OD023288, UG3/UH3OD023342, UG3/UH3OD023349, UH3OD023286, UG3OD035533, UG3/UH3OD023348, UG3/UH3OD023285, UG3/UH3OD023290, UG3/UH3OD023272, UG3/UH3OD023249, UG3/UH3OD023305, UG3/UH3OD023337, UG3OD035508, UG3OD035509, UG3OD035513, UG3OD035532, UG3OD035516, UG3OD035517, UG3OD035518, UG3OD035519, UG3OD035521, UG3OD035527, UG3OD035540, UG3OD035543, UG3OD035537, UG3OD035529, UG3OD035542, UG3OD035550, UG3OD035536, UG3OD035544, UH3OD035533
Research reported in this publication was supported by the Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core), U24OD035523 (Lab Core), ES0266542 (HHEAR), U24ES026539 (HHEAR Barbara O'Brien), U2CES026533 (HHEAR Lisa Peterson), U2CES026542 (HHEAR Patrick Parsons, Kannan Kurunthacalam), U2CES030859 (HHEAR Manish Arora), U2CES030857 (HHEAR Timothy R. Fennell, Susan J. Sumner, Xiuxia Du), U2CES026555 (HHEAR Susan L. Teitelbaum), U2CES026561 (HHEAR Robert O. Wright), U2CES030851 (HHEAR Heather M. Stapleton, P. Lee Ferguson), UG3/UH3OD023251 (Akram Alshawabkeh), UH3OD023320 and UG3OD035546 (Judy Aschner), UH3OD023332 (Clancy Blair, Leonardo Trasande), UG3/UH3OD023253 (Carlos Camargo), UG3/UH3OD023248 and UG3OD035526 (Dana Dabelea), UG3/UH3OD023313 (Daphne Koinis Mitchell), UH3OD023328 (Cristiane Duarte), UH3OD023318 (Anne Dunlop), UG3/UH3OD023279 (Amy Elliott), UG3/UH3OD023289 (Assiamira Ferrara), UG3/UH3OD023282 (James Gern), UH3OD023287 (Carrie Breton), UG3/UH3OD023365 (Irva Hertz-Picciotto), UG3/UH3OD023244 (Alison Hipwell), UG3/UH3OD023275 (Margaret Karagas), UH3OD023271 and UG3OD035528 (Catherine Karr), UH3OD023347 (Barry Lester), UG3/UH3OD023389 (Leslie Leve), UG3/UH3OD023344 (Debra MacKenzie), UH3OD023268 (Scott Weiss), UG3/UH3OD023288 (Cynthia McEvoy), UG3/UH3OD023342 (Kristen Lyall), UG3/UH3OD023349 (Thomas O'Connor), UH3OD023286 and UG3OD035533 (Emily Oken), UG3/UH3OD023348 (Mike O'Shea), UG3/UH3OD023285 (Jean Kerver), UG3/UH3OD023290 (Julie Herbstman), UG3/UH3OD023272 (Susan Schantz), UG3/UH3OD023249 (Joseph Stanford), UG3/UH3OD023305 (Leonardo Trasande), UG3/UH3OD023337 (Rosalind Wright), UG3OD035508 (Sheela Sathyanarayana), UG3OD035509 (Anne Marie Singh), UG3OD035513 and UG3OD035532 (Annemarie Stroustrup), UG3OD035516 and UG3OD035517 (Tina Hartert), UG3OD035518 (Jennifer Straughen), UG3OD035519 (Qi Zhao), UG3OD035521 (Katherine Rivera-Spoljaric), UG3OD035527 (Emily S Barrett), UG3OD035540 (Monique Marie Hedderson), UG3OD035543 (Kelly J Hunt), UG3OD035537 (Sunni L Mumford), UG3OD035529 (Hong-Ngoc Nguyen), UG3OD035542 (Hudson Santos), UG3OD035550 (Rebecca Schmidt), UG3OD035536 (Jonathan Slaughter), UG3OD035544 (Kristina Whitworth), UH3OD035533 (Emily Oken).
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001826051700001
- Other Identifier
- 991022197290704721