Introduction

All naturally occurring metals and other elements are present in at least trace concentrations in soil, water, air, and organisms. Under certain conditions, these elements can accumulate to high concentrations, leading to developmental delays, neurological damage, and even death [1-5]. Due to the long-term consequences of prenatal exposure, many reproductive health professional societies have advocated for further research and awareness regarding prenatal exposure to essential and toxic elements [4].

Adverse fetal outcomes are most often associated with toxicity due to heavy metals such as lead or mercury [6-8], and little data exists to clearly establish a link between birth defects and maternal environmental exposures to trace essential elements or toxic elements. The importance of fetal birth defects on healthcare cannot be understated. The Centers for Disease Control and Prevention reports that major birth defects affect approximately 3% of births and contribute greatly to both infant mortality and billions of dollars in healthcare costs [9].

The underlying cause of most birth defects is unknown, with many genetic and environmental interactions theorized. The proposed mechanisms range from micronutrient deficiencies to DNA alteration through epigenetic changes. Prior studies have shown differences between urban and rural samples, and maternal serum levels of essential and toxic elements are thought to be influenced by diet, water source, and occupation [10].

The University of Mississippi Medical Center is a tertiary referral center for congenital birth defects. Given the varying environmental exposures of our rural and urban populations, we sought to determine whether there is a causal link between birth defects and prenatal exposure to excess or inadequate essential and toxic elements. Secondarily, we sought to determine if demographic differences exist based on maternal factors.

This data was presented at the American College of Obstetrics and Gynecology Annual Clinical and Scientific Meeting, April 30 to May 2, 2021, as a Virtual Presentation.